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THE MACMILLAN COMPANY 

WBW YORK • BOSTON • CHICAGO • DALLAS 
ATLANTA • SAN FRANCISCO 

MACMILLAN & CO., Limited 

LONDON • BOMBAY • CALCUTTA 

MSLBOURNS 

THE MACMILLAN CO. OF CANADA, Lm 

TORONTO 



THE 
DISABLED SOLDIER 

BY 'X 

DOUGLAS C. McMURTRIE 

Director, Red Cross Institute for Crippled and Disabled Men 

President, Federation of Associations for Cripples 

Editor, American Journal of Care for Cripples 

WITH AN INTRODUCTION BY 

JEREMIAH MILBANK 

Vice-Chairman, Committee of Direction 
Red Cross Institute for Crippled and Disabled Men 



THE MACMILLAN COMPANY 
1919 

y4U Rigics Reserved 






Copyright, 1919 
By THE MACMILLAN COMPANY 

Set up and electrotyped. Published January, 1919 



JAN 15 laie 



Type act in the Printing Department of the 
Red Cross Institute for Crippled and Disabled Men 



©CI.A5I2035 
^-0 \ 



r^ 



TO 

THE AMERICAN SOLDIERS GONE OUT TO FRANCE 

TO RISK PHYSICAL DISABILITY IN THE CAUSE 

OF FREEDOM AND RIGHT 



CONTENTS 



CONTENTS 

CHAPTER PAGE 

I. A Record of Injustice 1 

11. Breaks in the Wall 27 

III. Orders to Advance 34 

IV. First Steps to Self-Support .... 37 
V. The New Schoolhouse 49 

VI. At Work Again 79 

VII. Help or Hindrajice 96 

VIII. Hors de Combat 113 

IX. Out of the Darkness 120 

X. In Wake of Battles Din .... 134 

XI. The Step in Time 141 

XII. Brink of the Chasm 151 

XIII. Allies on the Continent 160 

XIV. Kingdom and Dominion . . . .185 
XV. Across the Firing Line .... 209 

XVI. For the U, S. Forces 223 



ILLUSTRATIONS 



ILLUSTRATIONS 

FACING PAGE 



Home Again Frontispi 



tece 



A Procession of Cripples 22 v 

Goldsmith and the Disabled Sailor ..... 23 

Where There's a Will 30* 

New Tools for a New Trade 31^ 

Back at His Old Job . . 38 ^^ 

An Early Start 39 

Improving the Mind 46 

American Boys **Carry On" 47^ 

India's Men Go to School 54 

The Future Shipworker 55 

A Cheerful Pupil 62 

A Motion Picture Operator in the Making . . 63 

Business as Usual 80 

A Busy Workshop 81 

Learning to Walk for the Second Time . . . . 114 

A *' Working Arm" in lieu of Nature's Own . . 115 

Poultry Raising for the Blind 130 

Surmounting a Double Handicap 131 ' 

A New Way to Sharpen a Scythe 164 

Back to the Soil 165 

Still in the National Service 194 

A Wage-Earner Once More 195 

The Enemy Conserves Man-Power 210 

At Work Again — With Four Artificial Limbs . . 211 



INTRODUCTION IX 



INTRODUCTION 

There has been evidenced in the past but scant public 
concern in the welfare of the disabled. It is probable 
that one reason for this has been the failure to advocate, 
in popular form, the logic of the arguments in favor of 
rehabilitation for self-support — arguments which have 
only to be made clear to meet with cordial and hearty 
acceptance. It is my hope that the present volume 
will go far to promote understanding of the real needs 
of disabled men, and enlist public interest in the cause 
of reconstruction. 

When the preparation of this book was first proposed, 
I urged that the project be carried through. That I 
was asked to write the introduction is presumably 
because of my connection with the Red Cross Institute 
for Crippled and Disabled Men, which was established 
in the spring of 1917 as the first specialized trade school 
in the country for the handicapped adult. 

One of the greatest problems to be met in the successful 
establishment of any new institution is the selection of 
a competent director. The Institute was peculiarly for- 
tunate in securing for this position the services of a man 
so well qualified by experience and training as Douglas 
McMurtrie. For the past eight years he has devoted 
a large part of his time and effort to study of the ob- 
stacles and prejudices that confront the disabled man, 
and the means of overcoming them. This interest has 
culminated in the unselfish devotion of himself, his time. 



INTRODUCTION 



his energy, and his enthusiasm to the many and complex 
activities of the institution which he so ably directs. 

Under his leadership the Institute has already proved 
its value and assumed an important position in the field 
of rehabilitation and re-education. His reward, while 
not pecuniary, will be the everlasting gratitude of that 
great army of unfortunate individuals who have formerly 
been derelicts on the rough seas of misfortune, but to 
whom now has been given a greater opportunity to face 
the future with hope and courage. 



Jeremiah Milbank 



PREFACE XI 



PREFACE 

In any new science there are few books but a great mul- 
tiplicity of pamphlets, periodical articles, and reports 
which baffle the reader who seeks to learn the state of 
knowledge on the subject. The rehabilitation of the 
disabled soldier is no exception to this rule and it has 
been necessary to go through hundreds of documents of 
an ephemeral nature to gain a clear idea of what prin- 
ciples have been developed and how these principles are 
actually being put into practice. 

This volume aims to present for the general reader 
such a statement of theory and practice. In view of the 
extent of the field requiring to be covered, the treatment 
is necessarily elementary. But in view of the wide public 
interest in the future of the disabled soldier, and the 
manner in which the new reconstructive work of redeem- 
ing injured men from the social and economic scrap-heap 
has laid hold on the popular imagination, it is felt the 
book may meet a distinct need. 

The book is entitled for the sake of brevity 'The 
Disabled Soldier.*' It might more properly be named 
'The Disabled Soldier, Sailor, and Marine," for in all 
countries the same opportunities are extended to the 
members of all branches of the belligerent service. The 
word ''soldier'* in the text should always be read, there- 
fore, with this qualification in mind. 



XU PREFACE 



The literary and scientific obligations of the author 
are extensive and almost too numerous to detail. It has 
not seemed feasible in a work of this kind to burden the 
text with footnotes and references, so an endeavor will 
be made to acknowledge the main sources of personal 
assistance and data. Most vital help has been freely 
given by members of the staff of the Red Cross Institute 
for Crippled and Disabled Men, among them Dr. J. C. 
Faries, Mr. Howard R. Heydon, Mr. Harry Birnbaum, 
Mrs. Donald Whiteside, Miss Florence Sullivan, Miss 
Gertrude Stein, Miss Ruth Underbill, Mr. Alexander 
Gourvich, Mr. Gustav Schulz, and Miss Letty L. Davis. 
Mr. Jeremiah Milbank, also of the Institute, and a dis- 
tinguished benefactor in the cause of the cripple, has 
been so kind as to write the introduction. These staff 
colleagues have not only helped generously in many ways 
during the preparation of the manuscript, but have also 
read the proofs to check them for accuracy and to offer 
suggestions. Their part in the production is most cor- 
dially appreciated. 

The individual chapters have been read by various 
authorities, to whom I am indebted for criticisms and 
suggestions and checking as to accuracy of statement — 
the chapter on ''First Steps to Self-Support'* by Lt.-Col. 
Casey A. Wood, M. C, U. S. A. and by Dr. Herbert J. 
Hall, of Marblehead, Mass.; 'The New Schoolhouse'' 
by Mr. W. E. Segsworth, Director of Vocational Training 
of the Invalided Soldiers* Commission of Canada, and 
by Dr. James C. Miller, now on the staff of the Federal 
Board for Vocational Education; the chapter entitled 



PREFACE XIU 



''Hors de Combat'' by Lt.-Col. David Silver, M. C, 
U.S.A.; "Out of the Darkness" by Lt.-Col. James 
Bordley, M. C, U. S. A., and director of the Red Cross 
Institute for the BHnd, and by Mr. C. F. F. Campbell, 
of the same Institute; ''In Wake of Battle's Din" by 
Lt.-Col. Charles W. Richardson, M. C, U.S.A.; 'The 
Step in Time" by Dr. Henry Barton Jacobs and by Mr. 
William H. Baldwin, treasurer of the National Associa- 
tion for the Study and Prevention of Tuberculosis; 
"Brink of the Chasm" by Major George H. Kirby, M.C., 
U.S.A.; "For the U. S. Forces" by Mr. Curtis E. 
Lakeman, of the Department of Civilian Relief of the 
American Red Cross. I have further received much of 
value from the comments and correspondence of Miss 
Grace Harper and Captain H. W. Miller, both with the 
American Red Cross in France. 

For the use of photographs illustrating the recon- 
struction of disabled American soldiers, I am indebted 
to the Instruction Laboratory of the Surgeon General, 
U. S. Army. 

From the literature much data has been gleaned. 
Some of the principal authors to whom acknowledg- 
ment should be made are Eugene Brieux, Dr. Maurice 
Bourrillon, Leon de Paeuw, Gustave Hirschfeld, Prof. 
Ettore Levi, Sir John Collie, Major Robert Mitchell, 
John Galsworthy, Sir Arthur Pearson, A. G. Baker, Dr. 
Konrad Biesalski, Dr. J. R. Byers, Dr. J. Dundas Grant, 
Lt.-Col. E. N. Thornton. 

The book has been set up in the printing department 
of the Red Cross Institute. The care taken by Miss 



XIV PREFACE 



Inez Rodimon, Mr. William J. Howe, and Mr. Aage 
Petersen, of the staff of that department, in putting the 
manuscript into type has materially lessened the work 
of the author. 

It may be noted in passing that the royalties on this 
volume have been assigned to the Red Cross Institute 
for Crippled and Disabled Men, as the director of which 
the writer has been privileged to serve in a volunteer 
capacity. 

Douglas C. McMurtrie 

311 Fourth Avenue 
New York 



RECORD OF INJUSTICE 



CHAPTER I 

A RECORD OF INJUSTICE 

Beyond reaches of history, the disabled man has been 
a castaway of society. In the far east, the tribes of 
ancient India turned out their deformed members to 
wander in the wilderness and perish of exposure; here 
in America, among the Aztecs, deformed persons were 
sacrificed in time of famine and need, or on the death of 
kings and great men. 

The disabled wolf is torn to pieces by the pack ; primi- 
tive society abandoned, expelled, put to death its dis- 
abled and deformed members. Superstition was no 
doubt partly responsible for this savage practice, but it 
is conceivable that it was in great measure due to purely 
material considerations. In an age when life was a bare- 
handed struggle against starvation and death from man 
and beast, the tribe must have felt that its crippled 
members were useless if not dangerous burdens. They 
had to perish in the ruthless struggle for existence. 

In the course of time, primitive man came to anticipate 
the operation of the natural law of selection by putting 
the deformed to death as soon as they were born. 

Yet, with the dawn of civilization and the development 
of pastoral and agricultural life, the condition of the 
cripple did not improve to the extent that might have 
been expected. Oriental peoples turned forth their 
cripples to wander in the wilderness, the inhabitants of 
India cast them into the Ganges, the Spartans hurled 
them from a precipice, the Hebrews banished them so 



2 THE DISABLED SOLDIER 

that their cripples had perforce to beg by the roadsides. 
The exposure of deformed and ''superfluous'* infants re- 
mained a widespread and long-lived practice. Among 
some peoples the motives underlying these customs were 
intentionally eugenic, in a primitive way; in general, 
however, they seem to have been partly economic and 
partly superstitious. With regard to the latter, the 
superstitious motives, it is a curious fact that whereas 
primitive peoples have frequently found something 
sacred — a touch of the divine — in persons afflicted with 
disorders of the mind, bodily deformity seems to have 
been quite generally regarded as a blight sent by the 
gods, a punishment for sin, evidence of traffic with 
devils. 

This belief that the physically deformed are spiritually 
unfit has left its trace in the Hebrew scripture. Moses 
decreed that a man blind, lame, brokenfooted, broken- 
handed, ''crooktbackt," or dwarfed should not make 
offering to the Lord lest the sanctuary be profaned. The 
Greeks, worshipping perfection in bodily form, looked 
upon the cripple as the incarnation of everything un- 
lovely, not only physically but mentally and morally 
as well. Thersites is described by Homer as possessed 
of every ugly attribute, deformed equally in body and 
mind. 

The history of the social attitude toward the cripple 
is bound up with the history of the development of 
charity. The literature of antiquity is rife with refer- 
ences to beggars and beggary; to give alms was held 
to be a kind of obligation, more or less automatically 
performed. With its performance, all social obligation 
was fulfilled. As a result of this attitude, kindly refer- 
ences to the cripple are rare in ancient literature. Job 



RECORDOF INJUSTICE 



recites as one of his benevolences that he was eyes to 
the blind and feet to the lame. In one of the sacred books 
of the East it is stated that the inheritance share of a 
son crippled in both feet or maimed in both hands should 
be twice the share of one who is sound. 

The most highly developed civilization of antiquity, 
that of Athens, provided a system of relief for those of 
its citizens who were unable to earn a livelihood on 
account of bodily defects and infirmities. The qualifi- 
cation was a property test: it had to be proven that the 
applicant had no property in excess of three minae 
(about $100 in present purchase values). The senate 
examined the case, the ecclesia awarded the bounty, 
which was one or two obols a day — enough for a bare 
sustenance. 

The advent of Christianity struck a new note In the 
attitude toward the crippled and the deformed. Even 
in Isaiah's prophecy of the coming of the Messianic 
kingdom, he foretells that *'then shall the lame man leap 
as a hart." Christ, referring to his ministry, says: ''The 
blind receive their sight, and the lame walk.'* It is also 
related that the blind and the lame ''came to Him in the 
temple and He healed them.'* 

Many cures of cripples are attributed to the Apostles. 
"A certain man lame from his mother's womb" was 
healed by Peter. It is related that "immediately his 
feet and ankle bones received strength." During the 
ministry of Philip "many taken with palsies and that 
were lame, were healed." During the mission of the 
Apostle Paul to Lycaonia, he healed a cripple described 
as follows: "And there sat a certain man at Lystra, 
impotent in his feet, being a cripple from his mother's 
womb, who had never walked." 



4 THE DISABLED SOLDIER 

For all that it represented a distinct step forward, the 
new influence was not profound. The Christian Councils 
did their best to combat the ancient custom of exposing 
or abandoning deformed infants; but, despite their 
efforts and the laws of the Christian Emperors — Con- 
stantine, Valentinian, Justinian — the custom survived. 
Gradually, by way of humanizing this practice, the insti- 
tution known as the ^'turning slide'' became a feature of 
church doors; the deformed foundlings thus received 
were taken care of in creches, hospitals, asylums, refuges 
for the blind, the deaf, the crippled, the defective. In 
590 A. D., St. Gregory reformed the administration of 
the church and of charity in the city of Rome in an 
elaborate manner; one of his provisions was that the 
sick and the infirm were to be superintended by persons 
appointed to inspect every street. But the recognized 
mode of providing for the disabled remained in general 
what it had been in antiquity — almsgiving in response 
to begging. In Constantinople pauperism became so 
extreme during the fourth century that the Emperor 
Constantine decreed that all able-bodied beggars were to 
be condemned to slavery; the inference that beggary 
was to be reserved for the disabled is quite apparent. 
In Queen Elizabeth's day, more than a thousand years 
later, we meet the phrase ' 'sturdy beggars'* with a similar 
implication. Between these dates we have Charlemagne's 
order that no one was to presume to give relief to able- 
bodied beggars unless they were set to work. 

In all justice to the Middle Ages it must be pointed 
out, however, that casual almsgiving was not the sole 
relief provided. The church was actively engaged in 
relief work, at first on a parochial basis, then on an insti- 
tutional. Side by side with the centers established in the 



RECORD OF INJUSTICE 



monasteries, there grew up a system of endowed chari- 
ties, also under church rule, for the care of the *'poor'' 
and the **sick'' and others in need of aid; it is fair to 
assume that the crippled and the deformed were in- 
cluded in these categories, although specific mention 
of them rarely occurs. Thus, along with other hospitals 
estabhshed at Canterbury in England during the twelfth 
century, there was one for *'poor, infirm, lame and blind 
old men and women/' That all these institutions pro- 
vided relief of the most primitive kind only need not 
be emphasized. 

Before pursuing further the gradual evolution of the 
relief afforded the crippled and the deformed, it will 
pay to consider the use which ancient and medieval 
society made of these unfortunates. 

As it developed in luxury and culture, antiquity found 
a characteristic employment for some types of the de- 
formed, especially for the dwarfed and the grotesquely 
shaped. There are extant ancient Greek representations 
of comic figures of this sort — forerunners, possibly, of 
the medieval court fool. Attic comedy made constant 
use of actors padded to simulate various types of de- 
formity. The tradition that has come down to us with 
regard to ^Esop presents the author of the fables as 
born to slavery and deformity; and although modern 
historians seem to be doubtful as to whether ^sop ever 
existed or not, it is significant that tradition has created 
such a personality and that the oldest writer to mention 
his person speaks of his appearance and his voice as con- 
tributing as much as his stories to the amusement of 
his company. 

But this comic exploitation of deformity, brutal as 
it must seem to us, is the brighter side of the picture. 



6 THE DISABLED SOLDIER 

Seneca has left an appalling record of how some Roman 
masters exploited deformed slave children as beggars. 
If, as they grew older, their deformities were not con- 
spicuous enough to excite compassion, the poor creatures 
were intentionally crippled to an even greater extent: 
their arms were cut off, their shoulders twisted so that 
they became humpbacked. If the day's earnings were 
not sufficient, the master rebuked the wretches, saying: 
''You have brought in too little, bring hither the whip; 
you can weep and lament now. Had you appealed thus 
to the passer-by, you could have had more alms and you 
could have given me more." 

The Middle Ages, like antiquity, exploited the appeal 
that physical deformity makes to a primitive sense of 
the comic. The court fool or jester was to be -found 
almost universally in the retinues of princes and often 
in the households of noblemen. The type literature has 
seized upon and immortalized was characterized less by 
physical deformity than by a certain superficial quick- 
ness of wit and power of repartee; by far the greater 
number, however, consisted merely of creatures who^by 
reason of deformity of mind or body were calculated to 
excite heartless laughter or ridicule. The institution 
was firmly entrenched for many years, despite many 
tendencies operating to improve the situation. Even a 
number of decrees passed by the Reichstag in the six- 
teenth century failed to obviate the practice. Not 
until the Enlightenment was the final stage reached and 
the custom abolished. 

Even after this time, the court fool was still in vogue 
in the Russian court, Peter the Great having so many 
jesters of this type that it was necessary to divide them 
into classes. When the Spaniards under Fernando 



RECORD OF INJUSTICE 



Cortez accomplished the conquest of Mexico, court fools 
and deformed human creatures of all kinds were found 
at the court of Montezuma. 

Seneca's picture of the inconceivable brutality of some 
Roman masters has its medieval pendant in the picture 
drawn by Sebastian Brant in his ''Narrenschiff/' This 
German satire was done into English by Alexander 
Barclay in 1509, under the title of ''The Ship of Fools." 
The following is a slightly modernized quotation from 
Barclay's version : 

Some other beggers falsly for the nones 

Disfigure their children, God wot, unhappily, 

Mangling their faces, and breking their bones 

To stir the people to pity that passe by. 

There stande they begging with tedious shout and cry, 

Their own bodies turning to a strange fashion 

To move such as passe to pity and compassion. 

Heartless ridicule, inhuman exploitation, and, with it 
all, *'pity and compassion." Add to this the superstitions 
— the belief in * ^changelings," in the *^evil eye," in satanic 
paternity, which the medieval mind generally advanced 
by way of "explaining" deformity — and the strange pic- 
ture is complete. 

If space permitted, it would be instructive at this 
point to consider in detail the role the cripple has played 
in literature. Allusion has already been made to Ther- 
sites, who serves Homer not only as a foil to the heroic 
splendor of Achilles and Ulysses, but also as a maker of 
trouble and sower of discord. In the Siegfried saga, the 
dwarf Mime plays a similar part. And in Shakespeare's 
Richard III we have a classic presentation of the cripple 



8 THE DISABLED SOLDIER 

as ^Villain." In the opening monologue of the play, 
Shakespeare gives us a glimpse of the psychology of the 
cripple as he conceived it : 

But I, that am not shap'd for sportive tricks, 

Nor made to court an amorous looking-glass; 

I that am rudely stamp'd, and want love's majesty 

To strut before an ambling wanton nymph; 

I that am curtail'd of this fair proportion, 

Cheated of feature by dissembling nature, 

Deform'd, unfinished, sent before my time 

Into this breathing world, scarce half made up, 

And that so lamely and unfashionable 

That dogs bark at me as I halt by them; 

Why, I, in this weak piping time of peace, 

Have no delight to pass away the time 

Unless to see my shadow in the sun 

And descant on mine own deformity. 

And therefore, since I cannot prove a lover 

To entertain these fair well-spoken days, 

I am determined to prove a villain 

And hate the idle pleasures of these days. 

Plots have I laid, inductions dangerous. 

By drunken prophecies, libels, and dreams. 

To set my brother Clarence and the King 

In deadly hate the one against the other; 

And if King Edward be as true and just 

As I am subtle, false, and dangerous, 

This day, etc. 

Shakespeare's learned and philosophic contemporary, 
Lord Bacon, in his **Essay on Deformity'' strikes a similar 
note, holding that '^deformed persons are commonly 
even with Nature; for as Nature hath done ill by them, 
so do they by Nature, being for the most part . 
void of natural affection." 



RECORD OF INJUSTICE 



Writing almost two centuries after Shakespeare, Schiller , 
in his earliest play, *The Robbers," presents an inter- 
esting parallel to Shakespeare's Richard III in the figure 
of Franz Moor, who says: 

I have potent reasons to be out with Nature, and on my 
honor I shall press them all . . Why did she burden me 

with this load of ugliness? Why me, of all people? . 
Verily, I believe she threw into a single heap all the despicable ele- 
ments of mankind, and baked me therefrom. Death and devils! 
Who gave her the authority to dower others with this and that, and 
to withhold these things from me? 

Later he cries out, pathetically enough, as if with a laugh 
of grim irony: 

But is it just to damn a man because of his deformity? In the 
most wretched of cripples there may shine a great and lovable soul, 
like a ruby buried in mud. 

In conformity with medieval tradition, Goethe in 
*Taust'' provides Mephisto with a limp. Stevenson's 
genial cutthroats in "Treasure Island** are variously muti- 
lated; and even one of our own present-day novelists 
has a penchant for legless and one-eyed villains! 

But, from the end of the eighteenth century down, 
literature has grown increasingly rich in imaginative 
works that are not obsessed with this idea of a relation 
between physical and moral deformity. From Quasi- 
modo to Little Eyolf, from Tiny Tim to Richard Cal- 
mady, the cripple has been presented with a freshness 
of vision and a realistic insight that mark the dawn of 
a new era for this social castaway. Perhaps the change 
cannot be more strikingly indicated than in the follow- 
ing translation from '*an old manuscript" first published 
in 1806; in its lonesomeness, its resignation, its poignant 
imagery, the little poem is a most revealing bit of the 



10 THE DISABLED SOLDIER 

true psychology of the cripple under adverse social 
conditions: 

Dear hand of God! 
Lighten my heart, 
Help me to find 
Fun in my smart. 
Methinks the dear Lord 
At toss-ball doth play, 
The harder he strikes me, 
The higher my way. 

Or I am a sapling 
A garden within, 
God is the gard'ner 
And bends me to Him, 
He cuts me and prunes me 
And bends every limb. 
So I may grow upward 
And nearer to Him. 

Oh, let me proclaim it, 
God cuts to the bone. 
He chips me and hews me, 
But I make no moan. 
You marvel and wonder? 
I think it His wish 
To sculpture an angel 
Out of my flesh. 

The dawn of a new era! It is probably fair to say 
that the old era was summed up and the new era pre- 
pared for by a Spaniard named Vives who published a 
book early in the sixteenth century on the subject of 
the management of the poor — a book which was trans- 
lated into several languages and widely read. Vives 
divided the poor into three classes: those in hospitals 
and poor-houses, public homeless beggars, the poor at 
home. He proposed a census of the poor in each 



RECORD OF INJUSTICE 11 

town and the collecting of data as to the causes of 
distress. Then he planned the establishment of a central 
organization of relief under the magistrates. Beggary 
was to be strictly prohibited; work was to be provided 
for all. The non-settled poor who were able-bodied 
were to be returned to their native homes; the able- 
bodied settled poor who knew no craft were to be put 
on some public work — the undeserving being set to hand 
labor; for the others, work was to be found, or they were 
to be assisted to become self-supporting. Hospitals 
were to be classified to meet the needs of the sick, the 
blind, the insane. Funds were to be obtained chiefly 
from private sources and from the church. 

The Sorbonne approved this scheme; the city of 
Ypres put it into effect in 1524; similar plans were 
adopted in Paris and elsewhere. Queen Elizabeth's 
Poor Relief Act of 1601 was largely based on it. It 
was an ambitious scheme for the administrative tech- 
nique of the age; but, whatever its success, it had in 
it the seed of a rational approach to the problem of 
the poor in general and of the disabled and the de- 
formed in particular. 

Influenced, it may well be, by this Spanish book, 
President de Pomponne de Believre founded in France 
in 1657 an asylum in which the infirm could find suitable 
work. Despite several sporadic imitations of this project, 
which later became the Salpetriere, the early measures 
did not in a strict sense mark the beginnings of care for 
cripples, but they operated to the ultimate advantage of 
those who, by reason of their infirmity, were cast upon 
the pity of their fellow men. The actuating motive of 
provision in many cases, however, was utilitarian in 
character. One object — an object avowed by Vives, for 



12 THE DISABLED SOLDIER 

instance — was that all cripples might be so confined that 
they should not annoy the community by their deformed 
appearance, and the streets and highways be rid of 
beggars. 

Some of the many monasteries which had not been 
utilized since the time of the Reformation were thrown 
open and converted into orphan asylums, mad-houses, 
or penitentiaries. In the establishment of the various 
institutions the cripple was frequently considered. For 
instance, those handicapped by deformity were provided 
for at a hospital for wretched and pauper invalids estab- 
lished at Pforgheim in 1722 by Count Luitgard of Baden. 
This was later transformed by Count Charles Frederic 
of Baden into an orphan asylum, making especial pro- 
vision, however, for young and old cripples. According 
to the official ordinance creating this institution, the 
third class of inmates was to be composed of '*those who 
have such physical defects that they are an especial 
abomination and disgust to other men whenever they 
come into their sight.*' The cripple department was, 
however, abolished in 1808, probably because the quar- 
ters were needed for the insane. 

Such provision for cripples, however, gave them asylum 
only and did nothing to better their condition. The rise 
of the science of orthopedics was responsible for the 
ensuing improvement. The theories of the various ortho- 
pedists were best put into practice in an institution, and 
a large number of these were founded in the first decades 
of the nineteenth century; as, for example, those lo- 
cated at Paris, London, Leipzig, Lubeck, Berlin, Vienna, 
and Stockholm. 

The first institution in the world with an all-around 
program for ameliorating the lot of the cripple was 



RECORD OF INJUSTICE 13 

established in Munich in 1832, but this was devoted 
particularly to the care of crippled children. A long 
period followed before the creation of the second estab- 
lishment of the same sort which came into being in 
Copenhagen in 1872. From this time on, the number 
of schools for crippled children rapidly increased. 

But for the care of the disabled adult there was 
no provision at all. 

In the foregoing sketch of the history of the social 
attitude toward the crippled and disabled individual, no 
mention has been made of the care of the war cripple, 
the disabled soldier. The subject deserves a section to 
itself, despite the fact that in its broad outlines it parallels 
the tragic history of the care of the cripple in general. 

Historians have done very little to lift the veil that 
covers the fate of the disabled soldier of ancient times. 
In view of the limitations of primitive medical and sur- 
gical science, and of the custom of dispatching the enemy 
wounded after the field had been won, there is every 
reason to believe that it is a bloody veil. It is recorded, 
however, that ancient Athens fed its disabled soldiers at 
the state's expense, and that Rome under Augustus paid 
for the keep of its disabled legionaries out of public funds. 
Veteran legionaries were often provided for by grants of 
settlements on the frontiers of the empire. 

During the Middle Ages, when warfare was on a 
feudal basis, only those sufficiently well-off to equip 
themselves took part in military enterprises; they were 
relatively few in number and usually able to care for 
themselves in the event of permanent disability. At the 
time of the Crusades, Philip Augustus of France enter- 
tained the project of a hospice for disabled soldiers. The 
Pope congratulated him on his plan, and endowed the 



14 THE DISABLED SOLDIER 

institution in advance with certain privileges. St. Louis 
of France, returned from the Crusades with his shattered 
hosts, did actually establish an asylum for some 300 
soldiers blinded by *'the Asiatic sun.*' In most cases, 
however, the disabled soldier was thrown upon private 
charity for support. This duty devolved upon the lord 
who had brought his vassals to the king, and upon the 
monasteries. 

With the crumbling of the feudal system, and the 
development of standing armies during the fifteenth 
century, the professional soldier came into being. And 
from that time on, the disabled soldier was a recognized 
type. 

How was he provided for? For a time shift was made 
with the dispensation of private charity, monastic and 
otherwise. Supplied with the proper credentials, the 
disabled soldier would present himself at a monastery, 
and, after promising to obey the rules and to wear the 
garb of the institution, he would be admitted as a lay- 
monk. Few, however, found the life endurable. A 
French writer of the sixteenth century described the 
conditions in these terms: **Once the poor soldier is 
received [into the abbey], he may not abide a fortnight 
before most of the monks, deriding his hardships, his 
perils, his wounds ... do put so many obstacles in 
his path that he is fain to compound for a pension of 
fifty or sixty livres and betake himself elsewhere." De- 
parting, the soldier would sell his annuity for a trifle, 
which he would spend on drink, speedily lapsing into 
the ranks of beggars and cutthroats with which the 
countryside was infested. 

In England, with the expropriation of the monasteries, 
the disabled soldiers were thrown wholly upon the charity 



R E C ORD OF INJUSTICE 15 

of their leaders. In Queen Elizabeth's time, the captains 
of forces in Flanders complained that they were expected 
to make provision for the sick and wounded "whose 
charge lay heavily on them." The Queen was ''troubled 
whenever she took the air by these miserable creatures.** 
Toward the end of her reign, steps were taken to provide 
for ''maimed, hurt, or grievously sick soldiers," but little 
good was accomplished. 

From this point on, in the interests of clearness, it 
will be advisable to trace the history of the care of the 
disabled soldier in France, first, and then to return to 
England, and then to review the provident measures as 
they were developed in America. Italy and Germany, 
politically disorganized in great measure down to the 
latter half of the nineteenth century, have little to offer 
that is interesting until we come to very recent times. 

In France, then, toward the end of the sixteenth 
century, after the close of the civil wars, the problem 
finally became acute. A multitude of crippled and 
broken soldiers appealed to the victor, Henry IV, for 
the "means to live at ease the rest of their lives." They 
were all ruined men, they said, because either they had 
several times endured capture by the enemy and had 
been obliged to ransom themselves, or else they had 
been wounded and had expended their worldly goods 
for medical treatment. "They had been reduced to 
beggary, a shameful thing for the military order." The 
king was touched ; and after considering various expedi- 
ents, hit upon the idea of providing a hospice for the 
war disabled. 

To this end, he took over an asylum that had been 
established for orphans who were to become apothe- 
caries, changed its name to the Maison Roy ale de la 



16 THE DISABLED SOLDIER 

Charite chretienne, and decreed that the institution was 
to be supported by all the excess revenues that could 
be found in the budgets of the charitable institutions 
— chiefly monastic — in France. To gain admittance, the 
wounded soldier had to present a certificate from his 
captain or colonel stating how long he had served, the 
''combats, perils, and hazards he had been exposed to," 
his 'Valor,'* and in what ''military actions'' he had been 
wounded. 

Unfortunately, however, the commissioners of the in- 
stitution were unable to collect a single livre from the 
administrators of the charitable institutions in France. 
Their budgets, so the administrators declared, contained 
no surpluses! In a few years the institution was prac- 
tically defunct. In 1611, Louis XIII, successor to 
Henry IV, closed the doors of the Maison and returned 
it to the embryonic apothecaries. The disabled inmates 
who had survived were pensioned, and very liberally. 

But only for a little while. The need for state funds 
soon operated to reduce the annuities. The pensioners 
complained. "We receive," said they, "a mere alms, 
both odious and repugnant to the deserts of our quality, 
for the most part gentlemen, captains, and men full of 
honors and courage." The pension system was revised. 
Again the monasteries were drawn upon for funds. Each 
monastery was to support its quota of disabled soldiers. 
But the pension was inadequate, the red tape and trouble 
involved in collecting it was interminable. Before long 
most of the soldiers had sold their pension rights, and 
again the countryside was terrorized by wandering 
beggars, thieves, and cutthroats. 

Convinced of the defects of the system, Louis XIII 
abandoned it, and took up the institutional idea his 



RECORD OF INJUSTICE 17 

father before him had essayed. He planned generously, 
and undertook construction in 1633. This new venture 
was destined to be the prototype of the famous Hotel 
des InvalideSy the idea of which is usually attributed to 
Louis XIV. 

Very little is known of the history of the institution 
thus established by Louis XI I L In 1646, an official 
report declared that the building lodged only a gate- 
keeper, a pot-house, and the architect who had designed 
the structure; nowhere was there a soldier to be found. 
Doors and windows gaped, the roof leaked. In 1656, 
the building was given to the general hospital of the 
Salpetriere, which used it for the aged poor, as a mad- 
house, and as a prison. 

Louis XIV returned to the pension system, combining 
with it the plan of appointing the less severely disabled 
to garrison duty in the frontier towns. But there these 
unfortunates were so badly off that they declared "they 
had rather beg than submit to the posts that had been 
assigned them.*' The old abuses and disorders reap- 
peared. In order to curb them, the king ordered that 
all disabled soldiers caught begging in the city of Paris 
were to be hanged; whoever gave them alms was to be 
fined 100 livres. All to no purpose. The situation be- 
came critical; to solve it, Louis XIV revived the insti- 
tutional Idea. 

The establishment, like everything else undertaken by 
Louis XIV, was on a magnificent scale. It was to house 
4,000 pensioners. The king resorted to the monasteries 
for funds, but the yield was inadequate. In 1682 he 
decreed that on every Uvre that was spent for military 
purposes a tax of two deniers, later raised to three, was 
to be contributed to the support of the soldiers* home. 



18 THE DISABLED SOLDIER 

During the war of the Spanish Succession, this sum 
amounted to 1,250,000 livres a year. The future of the 
institution was secure. 

All in all, measured by the ideals of its time, this latest 
venture w^as a great success. In the fourteen years 
between 1676 and 1690, over 5,000 soldiers applied for 
admission; during the next fourteen years, over 10,000. 

A brief description of the Hotel des Invalides, as the 
institution was called, is desirable, for there can be little 
doubt that it served as the inspiration, if not the model, 
for the soldiers* homes that were later established in 
most civilized countries. 

The superannuated and the infirm constituted the 
majority of the population of the Hotel. On the eve of 
the Revolution, over a century after its establishment, 
out of 3,000 inmates, 1,107 were old men between seventy 
and ninety- two years of age, 1,488 had suffered amputa- 
tions or were otherwise wounded, decrepit, or infirm, of 
whom 72 were provided with wooden legs, 62 were one- 
handed, 4 minus both arms, 203 blind, 2 with silver 
noses, 129 on crutches, 185 helpless, and 68 idiots. 

The house was organized first and foremost for the 
care of the aged and the sick. More than half the per- 
sonnel spent all their days in the infirmary, looked after 
by sisters of charity. A comrade was assigned to each 
man who was helpless enough to need constant assist- 
ance, the former receiving a special allowance for his 
pains. 

The officers ate apart in special dining-rooms; the 
privates ate in two **shifts'* in four great refectories. Food 
was good and plentiful, including daily portions of meat, 
bread, and wine. The institution provided uniforms and 
shoes, and a pittance of fifteen sous a month. 



RECORD OF INJUSTICE 19 

The discipline was military^; the Hotel was like a gar- 
rison. There were special police, gate-keepers, sentinels. 
Everything was done to the roll of drums. Severe mili- 
tar>^ rule was supplemented by a moral discipline, which 
provided for compulsor\^ attendance at Sunday services, 
and heavy penalties for infractions of the rules against 
swearing, intoxication, fisticuffs. 

Amusements were rather limited, except for card- 
games and skittles. Some of the inmates worked little 
gardens. They were all permitted to work in their rooms. 
The administration even went so far as to provide tools 
and — for those who cared to learn — instruction in a 
trade. Those who were married, and whose families 
lived in the neighborhood, were given frequent permis- 
sion to visit their wives and children; but no one could 
marry without the consent of the governor. 

Certain marks of honor raised the institution above 
the level of a mere asylum; but personal liberty was 
greatly reduced, and many were glad to leave after a 
short stay. 

The king was not slow to notice that many of the 
disabled soldiers could, at a pinch, still render service, 
notably on garrison duty in frontier strongholds. The 
Hotel continued to clothe and feed those who were 
selected for this service, and gave them pay or half-pay. 
In 1736 there were 141 of these ''detached companies." 
Those who found life in the Invalides too dull asked 
nothing better than to be assigned to this service. 

Gradually the custom grew up of granting three years* 
leave to those who had families and longed to live with 
them, during which time the Hotel clothed them and 
gave them an allowance of at least 100 livres. Soon the 
three years* leave was extended indefinitely, the allow- 



20 THE DISABLED SOLDIER 

ances automatically becoming pensions. In 1790, in 
addition to 2,370 disabled men in the institution itself, 
there were throughout France 26,000 pensioned soldiers. 

Thus, the two principles of institutionalism and pen- 
sions — principles ultimately adopted by all the western 
nations — came to exist side by side in France, continuing 
down through the nineteenth and into the twentieth 
centuries. In 1831 the pension system was revised and 
regulated. The revised law based the pension awards on 
years of service, on rank attained, and to some slight 
extent on the seriousness of the disability. This law 
was still operative when the war of 1914 began. 

Today, the Invalides is little more than a magnificent 
war museum. It did not escape severe criticism even 
in its palmiest days. Voltaire regarded it as constituting 
in large measure a source of waste, holding that ''the 
discharged soldier might still labor and follow a trade, 
and give children to his country.*' Another French 
writer, Ardant du Pic, declared: **The Invalides is 
superb as a bit of apparatus, of ostentation. I wish 
that the original inspiration had been an impulse of 
justice, a Christian idea, and not purely one of military 
policy; nevertheless, the effects are morally disastrous. 
This assembly of idlers is a school of depravity in which 
the invalided soldier ultimately forfeits the right to be 
respected." 

The history of the care of the disabled soldier in 
France is largely typical of the history of this movement 
in other countries. In most nations, the administrative 
conscience awoke but tardily to an even approximately 
adequate sense of its obligations both to society and to 
the individual disabled in the most perilous of social 
functions. It will be remembered that in England, 



RECORD OF INJUSTICE 21 

toward the close of the sixteenth century, Queen Eliza- 
beth took ineffective measures for the relief of hun- 
dreds of soldiers who had been invalided home from 
Flanders. There seems to be no record of further public 
action until the time of the Commonwealth, when Par- 
liament made more effective provision, both in the form 
of pension grants and of soldiers* hospitals and homes, 
but only for those soldiers who had been disabled fighting 
for Cromwell. Crippled royalists received no consider- 
ation. When these partisan provisions were revoked by 
Charles II on his accession to the throne, the hitherto 
neglected royalist soldiers took advantage of the oppor- 
tunity to plead for provision. And in 1662 the king 
approved a measure enabling discharged soldiers to 
practise a trade without completing an apprenticeship — 
a measure which provided but sorry relief for those most 
in need of care, the severely disabled. 

In 1682, however, the king, prompted by the need of 
maintaining a considerable force and inspired, doubtless, 
by the magnificent example of Louis XIV of France, 
issued a decree for the establishment of the Royal Hos- 
pital at Chelsea for disabled soldiers. About the same 
time steps were also taken for the establishment of the 
Greenwich Hospital for invalided seamen. Both institu- 
tions were carried to completion under William and Mary. 

Chelsea Hospital was supported chiefly by money 
compulsorily deducted from the soldiers' pay. Not until 
the nineteenth century did Parliament provide more 
generously for the maintenance of the institution. In 
addition to the relief provided by these hospitals, a pen- 
sion system was inaugurated shortly after the opening of 
both establishments, based on disability incurred during 
service or on infirmity after twenty years' service. 



22 THE DISABLED SOLDIER 

Before long the numbers qualifying on this basis had in- 
creased so extensively that it was necessary to establish 
a system of ''out-pensioners/* organized into * invalid 
companies" and liable to special service in time of war. 

The pension system was subject to great abuses, the 
pensioners generally receiving but a fraction of the in- 
come (small enough in itself) they were legally entitled 
to. In 1754 William Pitt reformed the system, ''having 
it much at heart to redeem these helpless unthinking 
creatures from their harpies." 

Oliver Goldsmith, in one of his essays, quotes a dis- 
abled sailor who had been driven to begging at the 
outskirts of a town as saying to him: *'As for my mis- 
fortunes, master, except for the loss of my limb, and my 
being obliged to beg, I don't know any reason, thank 
Heaven, that I have to complain. Blessed be God, I 
enjoy good health, and will forever love liberty and Old 
England. Liberty, property, and Old England, Huzza!" 

Early in the nineteenth century. Parliament passed 
an act granting pensions to all soldiers who were inva- 
lided, disabled, or discharged after from fourteen to 
twenty-one years of service. Since then, and especially 
after the South African War, the system has been gen- 
erously extended, including relief not only for disabled 
and retired soldiers, but also for the widows and orphans 
of those dying in service. 

It is pleasant to be able to say that no nation has 
hitherto been so generous in its provision for the disabled 
soldier as the United States of America. In fact, the 
first relief measures were undertaken very shortly after 
the founding of the early colonies. Plymouth Colony was 
founded in 1620; it passed its first pension legislation 
in 1636, providing that any man who should be sent 




5<r.i,Jih,j, 



jCl dot Ob itn hUwn Iru^hilfAtk fhttTM Itfji 
Gatt mitA al QruibtU, of hfjJi jyitn 



Tiurom In Crutjitltn £>jlfchol> . vtd iimatn U,p, 
Otr jm ttn V(tt( brou< , /tn rtthttn ohawk. mt^Jw 



A Procession of Cripples, by Jerome Bosch, a fifteenth 
century painter who had a predilection 
for taking cripples as his subjects 



TZSJ'a^eJOS 




Si"i>Acirii del. 



JP.JHairen'cA j-cti(p. 



The Disabled Sailor Approaches Oliver Goldsmith. 
A Reproduction from a plate in an 1809 
edition of Goldsmith' s works 



RECORD OF INJUSTICE 23 

forth as a soldier and return maimed was to be main- 
tained competently the rest of his life. Eight years later, 
the Virginia Assembly passed a disability pension law, 
and not long thereafter another law creating a system 
of relief for the needy dependents of any colonist killed 
in the service of the colony. 

Long before the Revolution, other colonies had taken 
similar measures, Rhode Island not only providing pen- 
sions for the disabled and for the dependents of those 
killed in service, but also decreeing that every wounded 
soldier was entitled to medical care at the colony's ex- 
pense until cured. 

A few months after the beginning of the Revolution 
the Continental Congress declared that half-pay would 
be allowed every officer, soldier, and sailor incapacitated 
during the war. However, since the Continental Con- 
gress possessed neither funds nor any real powers, the 
pension obligations incurred by this and by similar reso- 
lutions rested solely upon the several states, some of 
which repudiated them. 

Several times during the bitter struggle, at critical 
moments when the outlook was gloomiest and the army 
discouraged. General Washington appealed to the Con- 
gress for more generous pension provisions. The oppo- 
sition to these proposals was always strong. A provision 
granting officers somewhat more favorable schedules 
than those set up for the men was violently denounced 
as undemocratic. 

The first general pension law enacted under the Con- 
stitution was passed in 1792 and amended the following 
year. In its amended form it provided that five dollars 
monthly (raised to eight dollars twenty-three years later) 
was to be paid all privates and non-commissioned officers 



24 THE DISABLED SOLDIER 

disabled in the service of the Continental Army. In- 
capacitated officers were allowed half-pay. 

This measure furnished the model for the regular 
army pensions law that was passed in 1802 and which 
continued unaltered in its essentials down to the Civil 
War. At various times throughout the first half of 
the nineteenth century special pension legislation for 
special groups, such as the widows of the Revolutionary 
soldiers, was enacted, the details of which need not be 
here discussed. During the Civil War the principle of 
fixed rates for specific disabilities — the loss of a hand, 
the loss of a foot, both hands, both feet, both eyes, etc. — 
was introduced, a principle which has since found fruitful 
application not only in military but also in industrial 
legislation. In 1870 it was enacted that artificial limbs, 
renewable every five years at public cost, be provided. 

In general, the tendency since the Civil War has been 
in the direction of unusual liberality. There is no need 
here for recording this legislation in detail. It is suffi- 
ciently well known to everybody that in some directions 
the system has been extravagantly extended, so that, in 
the words of an American general, *'It has come to pass 
that those who were merely on the rolls for a few days, 
and the malingerers and the deserters all march as 
veterans of the great conflict.** 

One other feature deserves mention, however. This 
feature is the state and federal Soldiers' Homes. The 
former number in excess of thirty, all told; in some of 
them the wives, mothers, widows, sisters, or daughters of 
the beneficiaries are maintained, as well as the disabled 
and invalided soldiers themselves. The total number of 
individuals maintained in these state institutions is 
about 11,000. The federal institutions are two in num- 



RECORD OF INJUSTICE 25 

ber, both situated in the District of Columbia. One of 
these, the National Home for Volunteer Soldiers, has ten 
branches in various parts of the country. The number 
cared for in the federal homes has varied between 18,000 
and 30,000. 

The lot of the industrial worker who is disabled by 
accident has in the past been very unfortunate. Up to 
a few years ago he had no redress except through the 
courts and the employer had many technical defenses 
which could be oflfered. For the most part the injured 
man slipped back in the social scale and frequently 
became dependent on relatives, or friends, or on public 
charity. 

Even after the recent advent of compensation legisla- 
tion which has done much to remedy the injustices in- 
volved in industrial accidents, the situation has not been 
greatly improved because while the money compensation 
went to support the man during the period of idleness 
ensuing the accident, it did nothing constructive to put 
him back on his feet again and to restore him to useful 
employment. Too often the man has lived on his com- 
pensation as long as it lasted and when it expired been 
forced to appeal for charitable assistance. Amputations 
and other injuries are great economic levelers, and it has 
been found in several studies that the skilled worker 
before the accident has been reduced after it to em- 
ployment as peddler, messenger, or watchman. In this 
process a vast deal of potential ability and productive- 
ness has been lost to the community. 

This statement gains force when it is considered that 
in eighteen states alone there are being injured in industry 
over 750,000 men per year. Over 35,000 of these acci- 
dents represent permanent disability either partial or 



26 THE DISABLED SOLDIER 

total. It IS estimated by competent authority that the 
permanent disabilities produced annually through indus- 
trial accident in all the states number over 80,000 of 
which over 2,000 represent total disability and over 
28,000 amputation cases. 

Up to modern times, therefore, the cripple has been 
always an object of charity if not of actual neglect and 
mistreatment. Public opinion has conceived the cripple 
as helpless and almost insisted that he become so. 
Charity has been readily proffered, but almost never the 
opportunity to make good and get back on his own feet. 
Educational advantages have been closed to the dis- 
abled man; the employer has refused him a job. 

Successful cripples are unanimous in evidence to the 
effect that the greatest handicap is not a loss of limb or 
other disability but the weight of public opinion. They 
have had to fight constantly against it in order to make 
their way and assume a useful place in the work of the 
world. 

Even the social workers who have a natural interest 
in all the unfortunate classes have been forced practically 
to give up the crippled man. There have been sporadic 
attempts in various large cities to operate employment 
bureaus for the physically handicapped, but in almost 
every instance the work was given up because it was im- 
possible to get employers to take men and because for 
disabled men who needed training prior to placement 
there was no possibility of obtaining the requisite edu- 
cational opportunity. 

For decades every indication has pointed to the need 
of special training facilities for the disabled. But the 
community did not see fit to provide them. 



BREAKS IN THE WALL 27 

CHAPTER II 

BREAKS IN THE WALL 

About the first move of a constructive character look- 
ing toward putting disabled men back on their feet must 
be credited to Belgium. In 1908 there was founded at 
Charleroi in the Province of Hainaut a school and shop 
for men crippled in industrial accidents. It was pointed 
out by a public spirited lawyer, Paul Pastur, that it 
was better to train the disabled for work which they 
could perform than to be content with paying them 
compensation and permitting them to remain in idleness. 
The subjects taught to the adult pupils in this Belgian 
school were bookbinding, shoe repairing, tailoring, sad- 
dlery, harness-making, and clerical work. There were 
likewise shops for the seriously disabled and older men 
for the making of grass carpet and baskets. 

Beginning one month after admission to the classes 
or shops the workers were paid a small stipend, and if 
they persevered and remained over six months they 
received pay for the first month as well. 

This pioneer experiment proved successful and the 
institution flourished. 

In 1897 there was established in Petrograd, in connec- 
tion with the Maximilian Hospital, a shop for the manu- 
facture of orthopedic apparatus and for the training of 
cripples in this trade. Later other equipment was 
acquired, and in 1901 residential facilities were estab- 
lished. Training has been given in the making of ortho- 
pedic appliances, rug-making, shoemaking, cabinet- 



28 THE DISABLED SOLDIER 

making, turning, brush -making, willow work, weaving 
and needlework, saddlery, and tailoring. Cripples be- 
tween the ages of fourteen and thirty are received for 
instruction, and the average course of training is four 
years in length. During the Russo-Japanese War the 
workshop was considerably enlarged. 

After the South African War there were established 
in Great Britain by the Incorporated Soldiers and Sailors' 
Help Society workshops for the employment of disabled 
soldiers. 

There were established in France in 1899 by M. Mar- 
soulan, under the auspices of the Department of the 
Seine, subsidized workshops for cripples and incurables 
of both sexes. The occupations carried on are the 
making of grass carpet, chair-caning, toy-making, and 
the like. These shops are more in the nature of relief 
agencies than training schools. 

A school similar in character to the one at Charleroi 
was organized by the Belgian province of Brabant just 
prior to the outbreak of the present war. Its plans were 
completely drawn and its equipment acquired, when the 
German invasion interrupted the enterprise. 

The advent of a new era for the disabled man, however, 
was marked by the establishment in Lyons, France, in 
December 1914 by Edouard Herriot, mayor of the 
city, of the first training school for invalided soldiers. 
M. Herriot found it difficult to reconcile the number of 
disabled men, strong and well with the exception of 
their specific handicap, who were sunning themselves in 
the streets and public squares in the city, with the des- 
perate need for labor in the local munition factories. 
His first impulse was to find jobs for these men, but he 
soon learned that the men who were unemployed were 



BREAKS IN THE WALL 29 

those SO handicapped as to be disqualified from returning 
to their former occupation. Before they could be re- 
stored to employment they must needs be trained in 
some trade compatible with their handicap. 

But a few months after the declaration of war — to be 
specific on November 30, 1914 — Mayor Herriot asked 
consent from the municipal council of Lyons to establish 
a training school for the mutiles de la guerre. On De- 
cember 16, a little over two weeks later, the school 
opened its doors and in the picturesque statement of 
French origin, *The Mayor welcomed the first three 
pupils, grasping them by their three hands.'* The school 
was housed in an eighteenth century building which 
belonged to the city. The pupils registered in ever in- 
creasing numbers and so great was the need that before 
long the old building in the Rue Rachais was outgrown. 
An annex to the school was therefore established on a 
farm property at the outskirts of the city. Soon after 
its foundation, the original school was christened the 
£cole Joff're and the new branch was designated as the 
£cole de Tourvielle. Both schools soon outgrew their 
accommodations. By October of the first year of oper- 
ation, it was necessary to turn applicants away. There 
was faced dther the necessity of further enlarging the 
plant or saying to the men injured in the recent combats 
in Artois and Flanders: 'We are sorry but you were 
wounded too late.'* The authorities at Lyons decided 
that they would not submit this excuse and at once de- 
cided to build new pavilions and open new courses. 

The schools are open to soldiers whose disability 
is such as to entitle them to pension. Men from any 
part of France, from the colonies, and from the allied 
nations are accepted as pupils, but preference is given 



30 THE DISABLED SOLDIER 

to those residing in the vicinity of Lyons or in the in- 
vaded sections of France. 

The length of course ranges from six to eighteen 
months. Instruction, board, lodging, and clothing are 
furnished without charge and no deduction is made from 
any pension which may have been awarded. Pupils not 
receiving pensions or allowances are paid by the school 
twenty cents a day for pocket money. The proceeds 
from the sale of work produced by the shops is discounted 
fifteen per cent, for running expenses and the balance 
divided among the pupil workers according to their pro- 
ductive capacity. 

At the school in the city are taught clerical work, which 
comprises bookkeeping, stenography, and typewriting; 
paper-box-making and bookbinding; toy-making, and 
beadwork. At the suburban branch are taught shoe- 
making, galoche-making, tailoring, carpentry and cabi- 
net-making, fur work, manufacture of artificial limbs 
and orthopedic appliances, wireless telegraphy, and horti- 
culture. Instruction in shop work in the manufacture 
of artificial limbs has been found most successful. The 
shop renders services which are considered indispensable. 
It studies the needs of the workmen in the different 
trades, designs useful appliances for them, and produces 
any special device needed for a given purpose. The 
trade is appropriate for men who have worked with 
either wood, metal, or leather, and has recruited its 
pupils from the ranks of men who were mechanics, 
blacksmiths, wood and metal turners, harness-makers, 
plaster workers, and shoemakers before the war. 

The course in fur work was started at the request of 
a number of fur merchants of the city of Lyons who 
were concerned over the shortage of workmen in their 




Where There's a Will. With both arms gone, this poilu has found 
a way to do useful work again. He was taught at Lyons ^ 
where the pioneer schools, of re-education were founded 



BREAKS IN THE WALL 31 

trade. They considered it a sound business measure as 
well as a humane and patriotic duty to create a supply 
of trained furriers to take the place of the Germans 
hitherto almost exclusively employed. The school was 
glad to open such a course, since the work can be done 
seated and is therefore suitable for men with amputated 
or paralyzed legs. A committee composed of five of 
the leading fur merchants of the city aided the school in 
organizing the course by inviting visits to their shops, 
by furnishing plans, and by selecting a foreman. After 
the class was started, they continued their cooperation; 
they supplied skins on which the pupils could work, 
paid them for their work, and promised definite posi- 
tions to those who finished the course. 

A wireless telegraphy section was started at Tourvielle 
as a result of a conversation between M. Herriot and 
Colonel Ferrie, technical director of wireless telegraphy 
in the Army. Colonel Ferrie regretted the lack of good 
operators and at a time when wireless stations were 
being multiplied so rapidly. ''So you want operators?" 
queried the Mayor of Lyons, "Good! I will provide 
them." 

A few days later, a complete school of wireless teleg- 
raphy had been organized at Tourvielle. Pupils were 
easily recruited; teachers were found in the Seventh 
Regiment of Engineers, and equipment was obtained 
from the radio serv^ice of Lyons. Without waiting for 
accommodations to be built, the class started in a little 
room in the main building which at other times was 
used as a smoking and reading-room. The pavilion 
afterwards built for the purpose is divided into five 
rooms — two private rooms for the teachers, a large class- 
room, a sound-reading room, and an instrument room. 



32 THE DISABLED SOLDIER 

Poles and antennae of the most modern type have been 
set up outside. 

In 1915 M. Herriot laid down the rule, 'The school- 
teacher should be the first instructor engaged by a school 
for the wounded/' Tourvielle has from the beginning 
had a school-teacher, and evening classes in school sub- 
jects have been held regularly from seven to eight every 
evening except Thursdays and Sundays. Classes are 
formed by grouping the pupils according to their pre- 
vious education and their needs. The illiterate have 
lessons in reading, writing, and arithmetic, while the 
more advanced listen to lectures on different subjects. 

These two schools at Lyons have proved the inspiration 
of and an example for over a hundred similar schools 
for disabled soldiers established throughout the French 
Republic. 

In all the other belligerent countries movements were 
soon under way to restore disabled soldiers to self- 
support. 

Belgium, under necessity of founding the institution 
on foreign soil, organized a school for the training and a 
factory for the employment of disabled soldiers. 

Great Britain was slow in starting, but has now 
worked out a satisfactory system for re-educating her 
disabled men. 

Italy followed very closely after the example of France 
and now has a series of local schools under the direction 
of a central committee at Rome. 

Throughout Germany there have been started by 
private and local initiative schools or training centers. 

Canada and the other British dominions recognized 
their duty to the men disabled in the war and set up 
public bodies to deal with the problem. And finally the 



BREAKS IN THE WALL 33 

United States has followed and will attempt to improve 
upon the example set by the other belligerents. 

"America, too, I know," writes John Galsworthy, 
''new as yet to this conflict and the wreckage thereof. 
Of that great warm-hearted nation, I prophesy deeds of 
restoration, most eager, most complete of all." May 
that generous prediction in generous measure be fulfilled. 

During a period of little over three years the disabled 
soldier has come into his own and instead of being com- 
pletely neglected is now offered thorough and modern 
facilities for training which will restore him to an inde- 
pendent and self-respecting position in the community. 



34 THE DISABLED SOLDIER 



CHAPTER III 

ORDERS TO ADVANCE 

The soldier who has done his duty in military service, 
has been wounded and permanently disabled, must not 
after discharge from the army resign himself to depen- 
dence on his pension and to spending the rest of his 
life in demoralizing idleness. He must still continue to 
do his duty. He has made good on the field of action 
and he must make good again in the field of civilian 
endeavor, even though handicapped through his patri- 
otic service. A line of one of our national anthems 
refers to the sounding of ''the trumpet that shall never 
call retreat, '* and in spite of his wounds, the disabled 
soldier must not lose his courage and retire from the 
front line of endeavor. He now receives from his country 
very definite orders still further to advance and he has 
yet before him opportunity to prove himself a good 
soldier and a worthy citizen. 

Now that nations have seen the light and are making 
effort to repair the injuries done their disabled soldiers 
in the past, the men themselves must play their part 
and help in every way possible to further the pro- 
gram. 

One of the greatest aids in putting the disabled soldier 
back on his feet is drawn from the example of men who 
have successfully taken advantage of the training oppor- 
tunities. In Great Britain the Minister of Pensions has 
issued a booklet entitled, ''What Every Disabled Soldier 
Ought to Know'' and which contains letters from men 



ORDERS TO ADVANCE 35 

who have graduated through training to success in 
civiUan employment. 

In schools for blind soldiers one of the principal func- 
tions is performed by blind men themselves who receive 
the newcomers and encourage them to start off with 
ambition to make their way under their new handicap. 

Most lasting help is derived from the example of 
civilian cripples who under the great handicap of public 
opinion in the past and with every disadvantage against 
them have made good. By force of superior character 
and initiative these men have overcome the same physical 
handicaps under which their less forceful fellows have 
gone down to economic defeat. At one school for dis- 
abled men, one of the most helpful features has been a 
series of meetings for an audience of cripples, addressed 
by crippled speakers. One of these speakers was a man 
whose extremities had been frozen by exposure in a 
blizzard, with consequent amputation of two legs, one 
arm, and four fingers of the remaining hand. He had 
then become for two years an inmate of the poor-house. 
He told the county authorities that if they would give 
him just one year in college, he would never again cost 
them a cent, persuaded them to do so, and made good 
his prediction. He later rose to be speaker of the House 
of Representatives in his home state, and is now presi- 
dent of a flourishing bank in the middle west. '*If 
your mind and spirit are straight,'' he says, **no other 
handicap can keep you down.*' 

Another speaker had one leg amputated and started 
under this handicap with no educational or financial 
advantages whatever. The best job he could get was as 
a shipping clerk, but he soon found there was no future 
for a disabled man in a manual and unskilled job. Under 



36 THE DISABLED SOLDIER 

great difficulty, he attended night school, and finally- 
obtained modest employment under civil service auspices. 
He now occupies a position requiring a high degree of 
expertness and experience. 

A third successful cripple who spoke at one of these 
meetings was a man who had lost both arms in an acci- 
dent; one is amputated at the shoulder, the other just 
below the elbow. He found almost hopeless difficulty 
in getting the first job, becoming meanwhile almost a 
vagrant. At last he obtained employment supervising 
a gang of unskilled laborers. From that point he has 
risen steadily. He has invented and manufactured his 
own appliances, with the aid of which he does practically 
every duty of daily routine — including putting on his 
collar and tie, engaging in a game of bowling, or pruning 
his own peach trees. He was elected by his county to 
be justice of the peace and later was thrice chosen for 
the responsible task of county judge. 

Such indomitable courage in the face of adverse 
circumstances cannot fail of inspiration to other men 
handicapped in the same ways. The disabled men 
themselves urge their fellows to obey the new order 
to advance. 



TO SELF-SUPPORT 37 

CHAPTER IV 

FIRST STEPS TO SELF-SUPPORT 

With the medical department of the military organi- 
zation lies the first responsibility and by all odds the 
greatest task in dealing with the disabled soldiers. A 
very large proportion — about eighty per cent. — of the 
men handled through the hospitals overseas successfully 
recover and return to the front for further service. 

Of those returned from overseas almost ninety per 
cent, are candidates for physical reconstruction only. 
About twenty per cent, are permanently disabled, par- 
tially or totally. Half of this number, however, are able 
to go back to their former occupation, without the need 
of re-education. The other half, or ten per cent, of those 
dealt with by the reconstruction hospital, require special 
training. 

It will be evident, therefore, that the task of caring 
medically and surgically for the injured soldier, is one of 
immense magnitude. It has taxed to the limit the 
facilities of the medical corps of our allies, and in pro- 
viding for similar work in this country, the Surgeon 
General of the Army will need and deserve the unstinted 
financial support of the legislative authorities and moral 
support of the people as a whole. 

The reason why this job of physical reconstruction of 
wounded men has not received wider public attention 
is that the marvels of medicine and surgery are not 
entirely new to us, while the economic reconstruction 
of the tithe of the total who would otherwise be destined 



38 THE DISABLED SOLDIER 

for the social scrap heap is of very recent development, 
and has seized upon the public imagination. Yet without 
the work of the medical corps, re-education would lack 
a sound foundation on which to build. 

In the reconstruction hospital of the present day, the 
injured soldier receives not only the standard and routine 
treatment but also attention from specialists, such as is 
available under ordinary circumstances to the rich man 
only. This intensive treatment continues as long as 
there is room for improvement. During its course occu- 
pational work with a therapeutic object plays a role of 
surprising importance. 

The current conception of a hospital pictures a large 
ward with rows of white beds along both sides, and with 
the occupants of the cots lying quietly back on the 
pillows waiting to get well. One can imagine the state 
of mind such an existence would engender. Every worry, 
every apprehension, every symptom possible of adverse 
interpretation would get one hundred per cent, attention 
from the patient. And in competition with this mental 
concentration on self and self's ills, there is nothing but 
the once-daily perfunctory statement of the doctor: 
"You are getting on very well." 

That a worried and fretful mental state has an injurious 
reflex upon the course of an invalid's recovery is well 
known. Any means, therefore, by which the mind may 
be occupied and directed to some other object than the 
patient's own ills may be expected to have beneficial 
results. 

Experience has shown that one of the most effective 
curative agents at the disposition of the physician is 
occupation. Simple work of the hands can be started 
while the patient is still ill in bed, and increased in 







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TO SELF-SUPPORT 39 

amount and consequence during the period of conva- 
lescence. So in recent years teachers of ^^occupational 
therapy'* or of * 'bedside occupations*' have come to form 
part of the staff of the best civil hospitals, and in the 
military hospitals they are now considered a necessity. 

From the point of view of mental therapy it matters 
little what lines of occupation are offered, provided they 
interest the men. The more fascinating and engrossing 
the work, the better the mental results attained. There 
must be some product in which the patients will take 
satisfaction — which perhaps they can take away at the 
end of their stay in the hospital — for without product 
interest cannot be long sustained. 

From the point of view of physical therapy, it is 
desirable — other things being equal — that the manual 
exercise involved shall contribute to the process of 
physical restoration. If a man with injured fingers can 
be set at an occupation which will bring the fingers 
actively into use, more will be gained than by many 
periods of.massage. The same principle applies to the 
more extended occupational work after the bedside stage. 

While primarily curative in object, the choice of sub- 
jects should also be considered from the economic point 
of view — though not to the prejudice of the physical 
results. A man is to be a long period in the hospital, 
and during his stay is to be occupied. If the simple 
experience and training can serve to brush up his skill 
in or extend his knowledge regarding the employment 
to which he will return, so much the better. In other 
words, his hospital occupation should be as purposeful 
as possible. 

In the early days of occupational therapy, the subjects 
were largely limited to those of the kindergarten: bead- 



40 THE DISABLED SOLDIER 

work, basket weaving, knitting, clay modelling, and the 
like. These are now coming to be added to and In many 
cases supplanted by more consequential ones such as 
typewriting, weaving of textiles, mechanical drafting, 
telegraphy, and It will be the duty of those carrying 
forward this work to add still further to the list. For 
the foreign speaking or the Illiterate the teaching of 
English is another excellent subject for hospital in- 
struction. 

If the patient understands the work to be useful he 
will enter upon it with more enthusiasm and vigor, and 
the results will be proportionately Improved. When the 
activity can in any way be related to the man's future 
job Its Import becomes even greater. It Is hardly fair 
to keep a man knitting when he may as advantageously 
take up some more masculine and practical occupation. 
These principles are coming more and more to be realized 
by the military medical authorities. 

One of the most Interesting branches of the medical 
work has as Its aim the restoration of function — over- 
coming limitation of movement In joints, re-training 
muscles, and the like. This work Is usually known as 
''functional re-education.'* 

The modern principle Is that the exercises to restore 
the Impaired function shall be active operations by the 
patient, rather than passive manipulations by hand or 
machine. At Hart House, in Toronto, Canada, there is 
in progress most interesting work of this character. All 
of the Instruments have registering dials so that the 
disabled man can see from day to day to what angle of 
motion, through his own effort, he attains. The visible 
improvement encourages him, and the showing on the 
dial is a constant incentive to excel his previous record. 



TO SELF-SUPPORT 41 

The process brings the patient face to face with his dis- 
abiUty, and leads him to concentrate upon the effort to 
overcome it. The man thus learns the habit of self- 
treatment and, even outside of regular treatment periods, 
does what he can to further his recovery. 

Another type of treatment to restore function consists 
in prescribed work in a curative workshop, a method 
already initiated in the more simple occupational ac- 
tivity. If he has a stiff elbow the soldier is set to work 
at a machinist's bench and in the interest developed in 
the work in hand, uses the file so as to give the joint 
highly effective exercise. In this instance the active 
exercise with a therapeutic end is unconscious — ^just the 
reverse of the situation in using the registering machines 
already described. The man hardly realizes, in his in- 
terest in the work itself, the curative object in view. 
One obvious advantage is that the exercise desired can 
be kept up most of the day, which would be impossible 
with a more formal system of treatment. 

In the words of the officer in charge of one of the British 
military orthopedic hospitals : *'If you give a man a damp 
rag and set him at work cleaning windows you will see 
that he is continually working his fingers as though 
grasping a spring dumb-bell. But while he would tire 
of the dumb-bell in a few minutes, he will clean windows 
for several hours without excessive fatigue." The man 
busy sawing a piece of wood going to make up the frame- 
work of a piece of theatrical scenery is really engaged in 
working an injured elbow back to health. The carpenter 
planing so vigorously has nothing manifestly the matter 
with his hands; in matter of fact he has a stiff ankle, 
but as he works he thrusts forward his right leg with 
each move in order to get more power into his stroke, 



42 THE DISABLED SOLDIER 

and in so doing unconsciously works his lame ankle all 
the time. 

Games and recreation play another important role in 
the curative process. They furnish a form of uncon- 
scious exercise for stiff joints and muscles. The compe- 
tition and enjoyment are also factors of positive value, 
bowling, quoits, badminton, hand-ball, billiards, and 
tennis have all found place in the program of recon- 
struction hospitals and convalescent homes. 

When physician, nurse, and hospital aid have done 
everything possible to advance the physical well-being 
of the wounded soldier, and it becomes evident that in 
spite of them all he will be permanently handicapped, 
the attack on his individual problem veers its direction. 
A plan for his future which will lead to usefulness and 
self-support must be laid out. More accurately the man 
himself must determine upon a plan for his own future, 
though he may be helped and guided to it by friendly 
counsel. 

The first difficulty is encountered in the acute de- 
pression and discouragement entailed in the serious dis- 
ablement of a healthy vigorous man — for the men on 
the fighting line are physically the flower of the com- 
munity. He knows the fate of his friends or fellow- 
workmen who have in the past been crippled, blinded, 
or otherwise injured. They have gone down many rungs 
on the social and economic ladder. The man who was 
a machinist became a messenger, the electrical worker 
became a watchman, the skilled baker now peddles 
pretzels, and the plumber now sells shoestrings on the 
street corner. Is it any wonder the outlook to the 
newly disabled man does not look bright? 



TO SELF-SUPPORT 43 

Again, it seems to him as though life would hold no 
pleasure in the future, and that he will always feel sen- 
sitive regarding his handicap. Besides nobody has much 
use for the disabled. And these deductions have much 
basis in precedent and observation. 

This state of mind will be encountered in the invalided 
soldier. It must be met early — in the base or special 
hospital abroad — and overcome. Arguments drawn from 
the black past history of the disabled must be outweighed 
by those drawn from the hopeful experience of modern 
practice. With returning health, initiative must be re- 
awakened, responsibilities quickened, a heartened ambi- 
tion must replace discouragement. We can go to him 
and truthfully say: ''If you will help to the best of your 
ability, we will so train you that your handicap will not 
prove a serious disadvantage ; we will prepare you for a 
job at which you can earn as much as in your previous 
position. Meantime your family will be supported and 
maintained. Finally, we will place you in a desirable job." 

To this end it is vital that doctors, nurses, and aids 
in the military hospitals abroad shall have a full realiza- 
tion of the principles and practice of ''reconstruction." 
They must be able to visualize to the man his future 
opportunities and possibilities so that, from the first, 
every contact and influence may operate to encourage 
rather even than to countenance despair. 

During the period of depression the only point of 
comfort is dependence on the pension which becomes 
the due of every disabled soldier and sailor. The man 
begins to figure on how he will manage to exist on the 
stipend which he will receive. And in most instances a 
small stipend it is indeed. In the United States the 
scale is the most generous of any country in the world. 



44 THE DISABLED SOLDIER 

Granted a constructive and effective program for the 
reconstruction of the disabled soldier and sailor, a low 
pension scale may be a blessing in disguise, in that it 
may force the men to make plans for support through 
their own efforts. Their first reaction, however, when a 
constructive plan is presented is fear that increasing 
their earning power may jeopardize their pensions, and 
a reluctance — until the pension is determined — to 
undertake any instruction which would improve their 
economic status. 

The success of any system of re-education is contingent 
upon a very clear understanding that pensions will not 
be so prejudiced. Most of the countries at war an- 
nounced that pensions were determined by physical 
condition alone. It was further stated that a man could 
take training and go out to earn more wages than he 
was paid as an able-bodied workman before enlistment 
and yet have his pension undisturbed. This did not 
sound credible to the men, however, and the facts had to 
be stated again and again. In all the Canadian hospitals, 
convalescent homes, and training schools placards setting 
forth this principle relating to pensions are prominently 
displayed. 

The only country to delay definite statement on this 
point was Great Britain, and her early re-educational 
work was greatly handicapped thereby. But in the most 
recent British pensions warrant a soldier totally disabled 
in military or naval service receives for his lifetime the 
sum of lis, 6d. per week. In proportion to rank this 
sum is increased. For pension rating a man is accounted 
totally disabled if he has lost two or more limbs, a limb 
and an eye, the sight of both eyes, or incurred other 
stated disabilities. He is regarded as being eighty per 



TO SELF-SUPPORT 45 

cent, disabled — and thus entitled to eighty per cent, of 
the total disability pension — if he has suffered the loss 
of both feet, a leg at the hip, a right arm at the shoulder, 
or the loss of speech. A short amputation of the thigh, 
the loss of a left arm at the shoulder or of right at or 
above the elbow is regarded as a seventy per cent, dis- 
ablement. The scale proceeds through a schedule of 
disabilities down to a twenty per cent, disability, for 
which one-fifth of the total disability rate is paid. For 
lesser injuries the man is paid, once and for all, a lump 
sum, termed a gratuity. 

The warrant states that 'Svhen a permanent pension 
has been granted it shall not be altered on account of 
any change in the man*s earning capacity, whether re- 
sulting from training or other cause." A certain injury, 
therefore, means a certain pension, and there is no 
authority with discretion to decrease the amount. 
When this was once clearly understood it made all the 
difference in the world in the attitude of the men toward 
re-educational proposals. Many men who have been 
trained are, with both their wages and pension, better 
off financially, than before their injury. For a man with 
both legs off, from the economic point of view clearly 
is not totally disabled, and even without a pension might 
earn more than before his enlistment In the army. 

With the pension difficulty out of the way, we must 
return to the effort to have the man decide to carry on 
to self-support. There are several considerations per- 
tinent to his decision. 

First is the attraction of the temporary war job. 
Under the abnormal labor conditions existing in time of 
war even a disabled man can go out and get employ- 
ment at an amazing wage. That such a job is temporary, 



46 THE DISABLED SOLDIER 

that it has no future, and that it affords no experience of 
value are truths only evident on second thought. They 
must be clearly demonstrated to the wounded man. 

In the second place the soldier has been long from the 
routine and responsibilities of the civilian community. 
His life has been one of danger and excitement, but as 
related to the ordinary functions of existence has been 
automatic, regulated in every particular. A man will 
view with reluctance a return to the responsibilities of 
a voluntary enterprise, such as his course of training 
will be. 

In illustration of this state of mind Major John L. 
Todd, of Canada, cites the case of a returned officer who 
found it difficult to make up his mind in the ordering of 
a meal from a menu placed before him. ''A civilian is 
accustomed to order his meals, to do everything for 
himself. He goes into the army and serves four years, 
during which time all his meals are chosen for him. The 
hour when he should go to his meals is decided for him. 
Suddenly wounded, he is no longer fit to be a soldier, 
and turned out into the world to unlearn just those 
things which have been taught him with such pains 
and effort.'' 

With regard to the reluctance to take up again a reg- 
ular routine, it can be argued that a man must, sooner 
or later, re-assume his civilian responsibilities, and that 
this will be much easier and more satisfactory if he has 
prepared to meet them. 

The third consideration is that the soldier has been 
away from home for a long period, and his most urgent 
desire is to get back to his family and friends. Against 
this desire, a discussion of prospects for the future does 
not seem to carry much weight. Tactful persuasion of 




-^•^^ 









TO SELF-SUPPORT 47 

the man, however, supported by the encouragement that 
the social workers dealing with the family are able to 
inspire can often effect the right result. 

And finally is the tendency of the disabled soldier to 
conceive that he has done his duty by his country and 
that he should now be supported for the rest of his 
natural days at national expense. This is largely a 
question of personal character. The weak and shiftless 
come easily to this servile point of view, the strong and 
self-dependent shun it vigorously. Again, the family 
influence will often be the deciding factor, and this can 
be largely moulded by the home service visitors. The 
adviser in the hospital has here a job in character building 
and it will be found that this type of effort is essential 
all through the rehabilitation process. 

Final decision on all these points of consideration will 
depend in large degree on the caliber of the men who as 
advisers are put in touch with the disabled soldiers. 
Personal strength and force are at a premium. The 
strong man will make a success of this preliminary work 
— the average man will fail. If it should be asked what 
is the greatest need of the disabled soldier the answer 
would be — not industrial school equipment, not elabo- 
rate courses, not splendid buildings — but the finest men 
the country affords to help him in the critical period 
immediately following disablement. Where there is 
found exceptionally successful work with injured soldiers, 
there will be found a man of unusual qualifications. In 
Great Britain experience has shown the need for picking 
most carefully the executive secretary of local war pen- 
sions committees to deal with disabled soldiers and 
sailors, for upon the man chosen turns the success or 
failure of work in the district. 



48 THE DISABLED SOLDIER 

It IS to be hoped that the one place where a re-educa- 
tional organization will not economize is in the salaries 
of the men to become the friends and advisers of the 
disabled soldiers. No precedent, no existing scale of 
payment, no red tape must interfere with taking for 
this work the pick of our human resources. Such an 
injustice to the returning service men could never be 
condoned. 



THE NEW SCHOOLHOUSE 49 

CHAPTER V 

THE NEW SCHOOLHOUSE 

Once the disabled soldier has made the decision to 
carry on, he should be given the advantage of a course 
of training wisely planned and capably executed. 

The plan of re-education is to train a man for a job 
in which he can perform one hundred per cent, efficiently 
in spite of his handicap, to find a process in the perform- 
ance of which the disability will be no drawback what- 
ever. With the wide variety of industrial processes 
today, it is entirely possible, with care and ingenuity, 
to find specific jobs which men with all types of handicap 
can follow. For the man with serious leg injury, there 
is sought a seated job; for the man with arm injury, 
work which can be done with one hand only; for the 
man with lung difficulty, outdoor employment; for the 
blind man, work in which the senses of hearing and 
touch are the primary essentials. . 

For even the most seriously disabled cases, well-paid 
jobs can be found. The manner in which the problem 
is approached can best be illustrated by several specific 
instances. A man with both legs off, if trained thoroughly 
as a linotype operator, can hold down his job and deliver 
as much product as his fellow workman with sound legs. 
He comes to work in the morning, sits down on his chair, 
and need not get up from it until the close of the working 
day. The work is all done by his hands. In this job is 
such a man disabled? 



50 THE DISABLED SOLDIER 

A man with one arm is trained as a painter and given 
a job in a furniture factory striping chairs, for which work 
he would use only one hand, even if both were sound. 

The man with lungs weakened by tubercular infection, 
gassing, or exposure, can be trained as a chauffeur and 
found a job at which he is in the open air all the time. 
In this way, his health is protected and his disability 
practically offset. 

The blind man can be trained to assemble the parts 
of small machinery. He is given the component parts 
on a bench at which he is seated and, beginning 
with the frame, adds part after part in regular sequence. 
Is this man at any disadvantage in comparison to his 
sighted colleague? 

Yet all these jobs are well-paid, and disabled men can 
be trained for them without difficulty. Preparation for 
them restores self-respect in that the man does not have 
to ask favors in seeking employment of such skilled 
character. 

It is not, of course, entirely easy to find just the job 
which men of different types of handicap should follow. 
Work of this kind is entirely new, and training in the 
highly skilled lines has not been attempted in the past 
by those who have been concerned in the education or 
placement of disabled men. Industry must therefore 
be examined in the most thorough and comprehensive 
manner in order that the jobs sought may be disclosed 
to the training and placement authorities. 

One of the best means to this end is the conduct of 
industrial surveys with the aim of disclosing employ- 
ment opportunities for the physically handicapped. In 
fact such surveys are essential to intelligent work for the 
disabled. 



THE NEW SCHOOLHOUSE 51 

When the British Pensions Ministry took over the re- 
sponsibility of training disabled soldiers for self-support, 
an arrangement was effected with the Department of 
Labor to make studies of openings in industry for dis- 
abled men. Each industry was considered by a com- 
mittee which was familiar with its possibilities, and the 
findings of this committee were published for the benefit 
of local training officials. 

Up to date these committee reports cover attendants 
at electricity sub-stations; employment in picture 
theatres; custom tailoring; agricultural motor tractor 
work; furniture trade; leather goods trade; hand-sewn 
custom boot and shoe making and repairing; gold, silver, 
jewelry, watch and clock jobbing; dental mechanics; 
aircraft manufacture; wholesale tailoring; boot and shoe 
manufacture; basket-making trade ; building trade; en- 
gineering; printing and kindred trades; picture frame 
making. 

The most complete investigations, however, have been 
carried out in Canada under the Vocational Branch of 
the Invalided Soldiers' Commission. Whole industries 
have been surveyed at first hand by competent investi- 
gators who bore in mind the needs of the soldiers in whose 
behalf the information was gathered. Before the work 
was started, a classification was made of the various dis- 
abilities which would be met with, and the availability 
of the trades to men with these handicaps was carefully 
recorded. In every report will be found a statement 
regarding the suitability of the trade for leg cases, arm 
cases, the deaf, and so forth. 

The surveys also comprised a full statement of the 
method and practice of the industry, so that placement 
agents and vocational officers might have a very clear 



52 THE DISABLED SOLDIER 

and succinct Idea of the trade requirements for which 
men are being prepared. 

In the United States some small beginnings have been 
made on similar work. It was found by the employment 
department of the Red Cross Institute for Crippled and 
Disabled Men that there was needed more accurate 
knowledge regarding the possibility of getting jobs for 
cripples in the leading industries of the city. Investi- 
gators were sent out in a very informal way to look into 
the openings in various trades and report back upon 
their observations. Over forty industries have already 
been studied in this way, among them the piano, leather, 
rubber, paper goods, shoe, sheet metal goods, candy, 
drug and chemical, cigar, silk, celluloid, optical goods, 
and motion picture industries. Similar work on a more 
ambitious scale has now been undertaken by the Harvard 
Bureau of Vocational Guidance, which has started with 
examinations of coppersmithing, the shoe industry, and 
rubber manufacture. 

Industrial surveys of the character described serve 
three specific ends: 

1. They show in what specific jobs the individual dis- 
abled man can be placed. If the man has general experi- 
ence in some trade, it is possible for the placement officer, 
w^ho could not otherwise know in detail the circumstances 
in a particular occupation, to send out the applicant with 
a good idea of what job he should apply for and with a 
very clear conception as to whether he is competent to 
hold it down. 

2. It gives educational officers a good idea as to the 
lines in which disabled men can be placed for training 
in factories or mercantile establishments under the 
apprenticeship method. 



THE NEW SCHOOLHOUSE 53 

3. The surveys oftentimes discoyer subjects which 
are desirable for school instruction of disabled men. As 
a matter of fact, when any particular Hne is under 
consideration for addition to the curriculum of a school, 
one of the best criteria of desirability is a thorough in- 
dustrial survey of the trade for which the course will 
prepare. 

The actual experiences of cripples who have been em- 
ployed in various trades will, if recorded, afford valuable 
data for the placement of other disabled men. In one 
employment bureau, it is the practice to ask every cripple 
in considerable detail regarding his employment record. 
If he found one trade possible with his disability or 
another one out of the question by reason of his handi- 
cap, these data are recorded and provide a good basis 
for dealing with another cripple of approximately the 
same handicap and experience. 

In picking out the subjects of instruction for a training 
school among those which surveys of the trades have dis- 
closed as possible for the employment of handicapped 
men, selection should be made according to the following 
criteria : 

1. The trade should pay well, as otherwise it will 
hardly profit the soldier to take a thorough course of 
training to prepare for it. It is frequently found that 
among trades which require almost equal ability and 
training, one will pay good wages and the other will pay 
poorly, due to commercial influences of one kind or 
another or to labor conditions. 

2. It is necessary to pick out a trade which is growing 
rather than on the wane. In other words it must be one 
in which there is constant demand for a new supply of 
skilled labor. Such a condition will insure steady em- 



54 THE DISABLED SOLDIER 

ployment and the prompt absorption into the labor 
market of graduates from the training course. 

3. Trades which are seasonal in character should be 
avoided. The placement of a disabled man is a fairly 
expert and careful job and it should not be repeated any 
oftener than is absolutely necessary. 

4. The trades selected as instruction subjects should 
be teachable and should not depend in too large degree 
upon native ability or talent. For example, some of 
the artistic or craft lines require almost an artist's 
ability, and among a large number of disabled men, there 
might be only one who could possibly take advantage 
of the training. 

5. And the trades must be teachable within a reason- 
able length of time. While men may be willing to defer 
for some months their return to regular employment, 
they will not have patience for a long period. Being 
adults, they would feel some of the best years of their 
life were slipping away from them and that the training 
was not worth the cost. At many schools in France 
instruction in tailoring had to be given up because it 
required eighteen months to bring a man to the point of 
proficiency, and the soldiers would not wait that long. 

6. The occupations for which training is given must 
not be those in which there must be expected labor dis- 
turbance or over-supply at the termination of the war. 
It would be hard, for example, to find an employment 
better suited to a one-legged man than automobile 
driving. Yet the British Pensions Ministry has sent out 
instructions that no disabled men are to be trained for 
this work. The explanation is that motor transport has, 
in the present war, displaced the army mule, and that 
tens of thousands of enlisted men have been trained to 




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THE NEW SCHOOLHOUSE 55 

drive the automobile trucks. These men are receiving 
the most versatile experience a chauffeur could have, and 
at demobilization they will be turned out into the civilian 
labor market to seek employment. The disabled man 
should not be submitted to this unusual competition. 

In actual practice the most popular trade being taught 
to crippled soldiers is ''motor mechanics," that Is, the 
operation and repair of automobile engines. Too popu- 
lar the school directors think it, for almost every man 
asked to express his preference as to subject elects to 
train as a motor mechanic. There could be no better 
proof that the automobile still has glamour in the public 
eye. The work manifestly appeals to the men's imagina- 
tions, and they want to go into it whether their ability 
lies in that direction or not. So the job of the vocational 
director is to dissuade many from this first and seemingly 
universal choice. Otherwise, according to one authority, 
'*all the disabled soldiers in Canada would be garage 
workers," and there would, of course, be available em- 
ployment for but a few of them. 

The aim of the courses is to train repair men for 
garages rather than chauffeurs. A specialized branch of 
automobile mechanics is the operation of agricultural 
tractors, an infant branch of the motor industry, but a 
growing one. Geographical influences determine this 
specialization. Whereas a motor class in Montreal will 
work with commercial trucks and pleasure cars, a similar 
class in a western province of Canada will take its training 
on farm tractors. 

The various branches of electrical work offer another 
good field of instruction. In London the Institution of 
Electrical Engineers, in cooperation with Northampton 
Institute, arranged courses to train switchboard attend- 



56 THE DISABLED SOLDIER 

ants for electric power houses, the classes being open 
free to disabled soldiers. The success of this work was 
proved by the employment of every man the day his 
course was completed. At other points in England war 
cripples are taught armature winding, magneto as- 
sembling, inside electrical wiring, and general repair 
work. In Germany there is electrical training at various 
centers, notably at the great school in Diisseldorf. There 
is little instructional work along this line in France. 
Electrical trades have the advantage of great industrial 
stability. They are growing steadily, the wages are good, 
andtheemployment is not subject to seasonal fluctuation. 

Another popular subject of instruction is moving pic- 
ture operation. This work is well-paid and fascinating 
as well. The employment demand seems unlimited as 
the number of "movie'* houses is growing every day. 
The training comprises simple work in electrical wiring, 
and operation of the projecting machines. Some of the 
latter now run by motor, do not require the grinding of 
a crank, and can thus be handled by men with certain 
arm injuries. 

To pass to a subject of another kind, cobbling has 
been found a good trade to teach a certain type of man. 
It is especially suitable for leg cripples. In large cities 
a reasonable number of men can be placed in shoe re- 
pairing shops, but in the smaller communities and in 
the rural districts the returned soldier can set up business 
for himself and build up a good trade. The required 
mechanical equipment is simple, and can be rented 
rather than purchased outright. This subject is taught 
in practically every country providing vocational re- 
education, but is particularly popular in France where 
it is represented at Paris, Lyons, Marseilles, Bordeaux, 



THE NEW SCHOOLHOUSE 57^ 

Cherbourg, Havre, Limoges, Montpellier, Rouen, Tou- 
louse, and at dozens of smaller centers throughout the 
country. Some of the French cripples combine with 
cobbling the repair of sandals and wooden sabots. 

The making of artificial limbs and orthopedic appli- 
ances has been found a good trade in which to instruct 
war cripples, and it is certainly as appropriate a line as 
any in which a maimed man could engage. This fitness 
is more than theoretical for most of the leg makers today 
are men who are themselves minus one or both of their 
lower limbs. In addition the trade is in a boom condition 
at the present time due to the extraordinary demand 
for limbs for crippled soldiers. 

The number of trades being taught is legion. Their 
choice is usually dictated by the labor needs of the com- 
munities in which the particular school is located. 
Among those which have found fairly general adoption 
are tailoring, printing, telegraphy, machine tool work, 
sheet metal work, and toy-making. 

To illustrate the combination of trades taught at any 
individual school, the list of courses at a few of them 
may be of interest. At Montpellier are taught: shoe- 
making, tailoring, carpentry and cabinet-making, var- 
nishing, wood-turning and carving, metal-turning, me- 
chanics, tinsmithing, harness-making, binding, dental 
mechanics, hair-dressing, the manufacture of artificial 
limbs, operation and repair of automobiles, industrial 
design, and bookkeeping; 

At Diisseldorf: metal work, mechanical engineering, 
telegraphy, electrical work, carpentry, cabinet work, 
wood-turning and carving, locksmithing, sculpture, stone- 
cutting, painting, paper-hanging and plastering, printing, 
photography and etching, cardboard work, leather work, 



58 THE DISABLED SOLDIER 

bookbinding, dental mechanics, farming, stenography, 
typewriting, bookkeeping; 

At the Montreal Technical School: drafting, motor 
mecfianics, civil service, business, English and French, 
stenography, carpentry, French polishing, pattern- 
making, electric wiring, mathematics. 

After possible and favorable subjects of instruction 
have been selected, however, it still remains to fit the 
individual to a trade. For doing this there are no gen- 
eral rules, and for ten cases of exactly the same handicap 
there will be ten different industrial decisions. The 
matter is determined principally by the past occupa- 
tional experience of the soldier. He is a man, not a boy, 
and his education has been gained more in employment 
than in school. The new beginning is made, therefore, 
with a certain vocational preparation which must not 
be wasted. The aim is to synthesize preparation for the 
future from two-thirds former experience and one-third 
re-education designed to utilize that experience under 
the new conditions of physical handicap. 

This rule has been followed universally by the re- 
education authorities in all the countries at war. The 
Germans report ability to return all but one man out of 
twenty-five to his own line or one closely related. In 
this way training requirements are minimized, and the 
man has the best possible foundation for his new start 
in the world of industry and employment. 

A few examples can show, superficially at least, the 
way this works out. A freight trainman who has left a 
leg behind him in the base hospital is not in shape to 
return to his old job. Let us presume that studies by the 
vocational authorities have shown that operating the 
keyboard of a type-composing machine is an excellent 



THE NEW SCHOOLHOUSE 59 

trade for a leg cripple — as it is. Shall the disabled train 
hand be re-educated as a machine compositor? The 
answer is emphatically no, for in this event all his rail- 
way experience would go into the discard. Special con- 
siderations not indicating to the contrary, however, the 
amputated soldier may be trained as a telegraph operator 
and sent back on the railroad to employment in a switch 
tower or the train despatcher's office, in either of which 
positions all his familiarity with rolling stock, train ' 
schedules, and general railway practice will stand him 
in good stead. 

There is added advantage in such a case that the man 
can be referred for work to his former employer who is 
fully acquainted with his record as to reliability and 
faithfulness. All the employer need then require is a 
certificate of the veteran's proficiency in his new role. 

On the other hand, presume a man who had been a 
hand compositor in a printing office came home with 
serious leg disabihty which precluded for the future his 
holding a standing job. Should this man be trained as 
a telegrapher, which proved a good trade for the other 
leg cripple? But again the answer is negative, for the 
precious print shop experience would be wasted. Train- 
ing as a proofreader, however, would put it to good use. 

Some men may be raised another peg in their own 
trade, and their employment education thus conserved. 
A building carpenter, who may suffer from one of the 
thousand-and-one disabilities which are not apparent, 
who is so weakened physically that he cannot go back 
to work handling beams and joists, can be trained in 
architectural drafting and the interpretation of plans 
and prepared for a position as a foreman or inspector of 
construction. His former experience will be the best 



60 THE DISABLED SOLDIER 

possible preparation for this job, for he will know all 
the tricks of the trade, and very little will get by 
him. 

An educator in one of the allied countries has pointed 
out that very frequently disabled men who have taken 
advantage of training go out to better paid jobs than 
they held before their injury. The position in any given 
line that requires less physical capacity usually is the 
one that requires more skill and head-work, and as such, 
carries with it higher earning power. 

The disabled farmer is somewhat of a special case, but 
he too should not abandon the occupation in which he 
is experienced. If he cannot return to pitching hay, he 
can be trained for poultry raising, dairy-work, bee 
keeping, or other of the lighter agricultural specialties. 
He will then not be subjected to the revolutionary change 
involved in transporting a confirmed countryman to 
industrial work in a large city — conditions under which 
he is extremely likely to be unhappy. 

There is another reason why the agriculturist should 
stay on the farm : that the nation may profit by the con- 
tinued labor of a food producer which it cannot afford 
to lose. In France there has been a country-wide 
propaganda to this end, and posters and booklets have 
set forth the exhortation: ''Agriculteurs, ne changez pas 
de metier.'' The movement from the farm to the fac- 
tory is already too pronounced, and in the European 
countries the farm workers have seen it was they that 
were sent first to the trenches, while many of the indus- 
trial employees were kept at home in the munition plants. 
Determined efforts have been made to counteract the 
trend, and great ingenuity has been addressed to the 
solution of difficulties in the path of the disabled farmer. 



THE NEW SCHOOLHOUSE 61 

There still remains to be considered the man without 
real occupational experience. A soldier of one type may 
have held in the two years prior to his enlistment ten 
different jobs — all makeshift in character and all ill paid. 
He may have left school at fourteen and been under the 
necessity of going to work to help support the family. 
In such an instance he would never have had a chance 
at a skilled trade. Now that he has gone abroad and 
been injured in his country's service, is this man to be 
denied the chance he missed earlier in life? It should 
be the pride of the community to give it to him. 

Representative of another type is the young man who 
may have gone into the army direct from high school. 
In the American forces, so largely made up of youngsters, 
cases of this kind will be numerous. When this youth 
graduates from military service, a disabled veteran, he 
should be provided with the same vocational advantages 
as he might have availed himself of had not the war 
rudely interrupted his educational career. 

With both these types there is no past experience to 
serve as an occupational determinant for the future. 
Choice is therefore free, and the usual principles of voca- 
tional guidance will apply. 

For the man with superior mental qualifications little 
assistance in readaptation is necessary. He will find a 
way to keep on with his work. Professional men can, 
in spite of even serious handicaps, continue in their own 
line. Disability does not mean as much to the head 
worker — architect, chemist, statistician, or designer, as 
it does to the manual worker — machinist, textile worker, 
stone mason, or shoemaker. 

Most of the men of mental qualifications who will 
profit by re-educational provision by the national authori- 



62 THE DISABLED SOLDIER 

ties, are the younger soldiers who can take up or con- 
tinue courses at universities or professional schools. The 
range of training should not be limited to the trades; 
the educational opportunity should only be conditioned 
by the talents and possibilities of the pupil. In Canada 
numbers of men have been sent to college with their 
living expenses and tuition paid by the government, 
and the same situation will doubtless ensue here to as 
great if not a greater degree. 

And finally, there is the man without enough mentality 
to make possible his training in a skilled trade. After 
it is clear that nothing can be done for him vocationally, 
he may, as a last resource, be equipped with as effective 
mechanical aids as possible to offset the handicap of his 
disability, and returned to manual labor. If foreign- 
speaking his chances may be improved by teaching him 
to speak English. Luckily, however, cases of this char- 
acter will be few among men of our own forces, by reason 
of the high standards of admission to and retention in 
the army. A densely stupid man would never get as 
far as the front line overseas. 

The courses of training must be intensive and practical 
rather than theoretical. Every feature of instruction 
must be evaluated according to whether it affords direct 
assistance to the man*s earning a living. A mistake that 
has often been made especially by universities and other 
institutions of higher learning is to give the disabled 
soldiers the elementary first-year schedule of a regular 
four-year course. This gives them a little of everything 
and complete familiarity with almost nothing. What 
must rather be done is to pick the essential and practical 
features out of the whole four-year program and condense 
them into the compass of a short course. 




A Cheerful Pupil. French soldiers at the Ecole Joffre, 
Lyons, learn to operate machines 



THE NEW SCHOOLHOUSE 63 

In place of grinding for a final examination upon which 
academic rating may be established, it is better to devote 
the last one or two months of training to practical work 
in the field for which the training prepares. When the 
students' association at Calgary, Canada — made up of 
the returned soldiers being trained at the Institute of 
Technology and Art — were asked for suggestions re- 
garding how the instruction might be improved, they 
answered that their chief concern was that they should 
know when they went out to a job just what was expected 
of them. The apprehension was that they might be 
made ridiculous and show up as inexperienced in com- 
parison with other workmen who might be hired for the 
position. To eliminate this possibility the men are put, 
before graduation, at actual work of the same character 
as will be required by their first employer. For example, 
the men training as operators of gasoline tractors are 
set to plowing virgin prairie and doing other miscellan- 
eous farm work, all under helpful supervision by their 
instructors. They go out, therefore, not as novices but 
as full-fledged workers. 

In like manner, at Winnipeg, Canada, the men who 
have been trained for clerical positions are put for the 
last month of the course in a model office, equipped with 
all the modern appliances such as adding machines, 
billing machines, filing systems of all kinds, telephone 
switchboard, and the like. Such equipment does not 
embarrass them, therefore, when they go to their real 
work. 

It has already been pointed out that courses must not 
be too long, and that this necessity serves to exclude 
some subjects from choice for the training of disabled 
soldiers. Nine months is as long as the average course 



64 THE DISABLED SOLDIER 

can wisely take, and one year is usually the limit. The 
Canadian authorities endeavor to make most of the 
courses come within six months. Many subjects can 
satisfactorily be taught in an even shorter time, for 
example, power station switchboard operating, oxy- 
acetylene welding, and so forth. 

A question closely related to the manner of teaching 
is that of character, source, and training of instructional 
officers. Whether they shall be drawn from the ranks 
of teachers or from among engineers or manufacturers 
is a subject of wide discussion. The tendency in Canada 
now is to depend on the latter source, the argument 
being that the problem is industrial rather than educa- 
tional, and a material proportion of the training is being 
done in shops. In Great Britain the solution is clear, 
since most of the work is done in already existing and 
organized technical institutes, whose regular staffs carry 
on the teaching. In the United States the first workers 
are being drawn from the vocational education field, 
some of the men having been given a special course of 
study in New York and travel and observation in Canada, 
in order that they may know how to apply their own 
particular technical experience to work with the disabled 
soldier. If such men serve as directors or vocational 
advisers, it is fairly simple to draw the actual instructors 
from trade workers and imbue them with the right 
social spirit in dealing with the men. It needs teachers 
of manifest experience and competence to command the 
respect of the disabled soldiers. 

It becomes of increasing importance as the war pro- 
gresses to recruit as directors and teachers returned 
soldiers who have seen service at the front. They get 
better work from their pupils and are in an infinitely 



THE NEW SCHOOLHOUSE 0^5 

better position to maintain discipline. The man wounded 
overseas tends quite naturally to regard stay-at-home 
citizens as slackers, and he demands employment of 
veteran comrades in their stead. 

It has required some courage in Canada to stand out 
against the demand for appointment to a job of a re- 
turned soldier of inferior qualifications rather than a 
civilian of marked ability. Now, however, the great 
majority of representatives of the Invalided Soldiers' 
Commission have seen overseas serv^ice. In the repatria- 
tion serv'ice of Australia the minister recently reported 
that ninety per cent, of the men on the payroll were 
returned soldiers. Immediately the voices of parlia- 
mentary members were heard in criticism that the pro- 
portion should have been still higher. 

If the militar\^ officers are used in any relation to re- 
education, it is practically essential that they be officers 
themselves invalided from the front. The soldiers 
regard the uniform as the badge of a fighting man, do 
not look kindly on its assumption by stay-at-homes, and 
practically refuse to acknowledge the authority of an 
officer who has not seen actual service. Of course, this 
necessity does not become operative until some little 
time after belligerency begins. 

In setting out to provide for the re-education of dis- 
abled soldiers what facilities should be employed? Can 
existing facilities be utilized or must special schools be 
erected or organized? 

The ideal arrangement would be to assign men for 
training — under national supervision and at national 
expense — to a special vocational school for the disabled, 
but these practically do not exist. The reason why this 
would be desirable is that the staff would be already 



66 THE DISABLED SOLDIER 

familiar with the particular difficulties of the disabled 
man, and experienced in dealing with him. The re- 
habilitation of the physically handicapped is not wholly 
an educational or industrial problem — it is very largely 
a social one. 

The men who might be highly successful in the voca- 
tional education of young men might fail of the patience 
requisite to the training of the disabled. Due perhaps to 
the past public attitude toward the crippled and blind, 
perhaps to expectation of future support by pension or 
compensation, perhaps to a feeling of helplessness on the 
part of the man for going out again into industry, there is 
certainly a psychology of disability and as surely a social 
philosophy for meeting it. Although preparation of teach- 
ers and directors by theoretical instruction and observa- 
tion may accomplish much, real capability is attained 
only by actual experience with the disabled man himself. 
This experience the special school for the handicapped, 
if operated on modern lines, brings ready to the task. 
But although every industrial community needs such 
schools, they do not exist. Dependence for the execution 
of an extensive national program must in consequence 
be placed on other means. 

The most useful facilities to hand are the existing 
vocational schools. These institutions have equipment 
and teachers and can undertake on short notice the 
training of disabled soldiers. It has been found neces- 
sary, however, to organize special classes for the soldiers 
rather than put them in the same classes as the boys 
under instruction. The men are mortified at the dis- 
crepancy in ages and being some time away from their 
school days are not as quick to catch on at first to class- 
room instruction. The necessity for special classes has 



THE NEW SCHOOLHOUSE 67 

been clearly demonstrated in Great Britain where the 
already operating technical institutes have been largely 
availed of. 

The utilization of these facilities is highly logical as 
it would be folly to purchase and install special mechani- 
cal equipment for the temporary- need involved in the 
rehabilitation of wounded soldiers. The only justifica- 
tion for organizing a special school for the disabled is a 
permanent program for the rehabilitation of the handi- 
capped — civilian as well as military-. In such instances 
the separate institution is not only permissible but 
desirable. 

The vocational schools have been very ready to come 
forw^ard with offers of their facilities. In Great Britain 
most of the great technical institutes have organized 
special classes in general trade subjects for the returned 
soldier; for example, the Regent Street Polytechnic and 
the Northampton Polytechnic in London, the Technical 
Institute, Birmingham, and the Newport Technical In- 
stitute in South Wales. The courses at these schools are 
approved by the Ministry of Pensions which also pays 
tuition of the men. 

Schools for teaching individual trades have also pro- 
vided facilities for the war cripple. Examples of this are 
the school of diamond cutting at Saint-Claude, celluloid 
industry at Oyonnax, cutler>^ at Thiers, and watch- 
making at Cluses, France; tool-making at the Metal- 
crafts Training Institute, boot repairing and leather work 
at the Cordwainers' Technical College in London. 

Another type of vocational school is represented 
by the business college or clerical school. These can 
organize special classes and enlist a fair number of 
pupils. Clerical instruction is provided in most of the 



68 THE DISABLED SOLDIER 

military hospitals, and some of the men taking this 
work reveal talents and aptitudes which lead to their 
taking up a clerical specialty as their re-educational 
subject. 

Still another vocational branch is agricultural training, 
which can be excellently provided by existing agricul- 
tural colleges. In France the national schools have 
made provision for the poilu put out of commission at 
the front; in Canada provincial schools of agriculture 
have undertaken the w^ork ; in New Zealand the Depart- 
ment of Agriculture is caring for the farm training of 
returned soldiers. 

Still another class of educational organization which 
can be utilized to advantage is the university. While 
the vocational school for boys may have its full quota 
of pupils, the university in war time is denuded of stu- 
dents. And most universities today have engineering 
or agricultural departments which, otherwise idle, can 
be made useful indeed. McGill University in Montreal 
is training under supervision and at the expense of the 
Invalided Soldiers* Commission a large number of 
returned men. The University of Saskatchewan at 
Saskatoon is preparing many for agriculture. In the 
other Canadian provinces the University of Toronto and 
the University of British Columbia are contributing 
splendidly to the national program. 

In conjunction with every military hospital giving 
reconstruction or long-time treatment some educational 
provision is necessary. Of course, this may consist only 
in teaching ward occupations and simple pre-vocational 
w^ork. But in many cases it has been found wise to start 
vocational training during the hospital period. In con- 
nection with every * 'center of physiotherapy*' in France is 



THE NEW SCHOOLHOUSE 69 

a re-educational school. In England, at the Brighton and 
Roehampton orthopedic and Hmb-fitting hospitals, have 
been organized schools in which the men start their 
vocational training, which is continued, after hospital 
care is finished, as a post-graduate course at one of the 
London polytechnics. 

During the early stages of the work in Canada, it was 
the practice to begin re-education while the men were 
still under medical care. Under new administration, on 
the showing of experience, a new ruling was made about 
the middle of 1918. This provided that no more men 
were to start industrial training until after discharge, 
and not then until after medical treatment was finished. 
Up to this point all occupation has a therapeutic objective 
and is carried on in curative workshops. 

In cities and districts where there are for one reason 
or another no vocational education facilities which can 
be turned to the training of disabled soldiers, there be- 
comes necessary the establishment of a special school of 
re-education to meet the need. There have been founded 
in this way a number of institutions which it is hoped 
will continue to train disabled industrial workers after 
the temporary need for the rehabilitation of soldier 
cripples has passed. 

The leading examples of this type of school are at 
Lyons, France, and Diisseldorf, Germany. The former 
has been already described. The latter serves the men 
under treatment at fifty hospitals in the city of Diissel- 
dorf or resident there after military discharge. 

In analyzing the past experience and employment pos- 
sibilities of an individual disabled man, the need for an 
extremely large number of instruction subjects is indi- 
cated. A recent listing of the subjects being taught to 



70 THE DISABLED SOLDIER 

returned soldiers in Canada showed a total of two hun- 
dred. When we proceed on the assumption that the 
individual is to receive training in the line for which he 
is best fitted, the variety of classes called for is beyond 
the range of any vocational school to provide. The 
question is then: How is instruction in the unusual 
subjects to be provided? 

This necessity has given rise to the re-establishment 
of the apprentice system. More and more dependence 
is coming to be placed on training in factories and indus- 
trial establishments. Under this system the fange of 
subjects is almost unlimited. 

The employer must be willing to undertake very def- 
initely the instruction of the soldiers, and detail one or 
more of his best men to this end. There must be regular 
supervision of the work and inspection of the progress 
made by the apprentice in order to guard against the 
employer using the men for routine production processes 
with little or no progress or educational value. He must 
not be allowed to regard their time as possible labor 
obtained free or at small cost. 

On the other hand, properly regarded, the system 
confers real benefits on the employer. In the first place 
it affords him a source of supply for skilled labor which 
may be very scarce and difficult to obtain; for most of 
the men trained in a factory stay on in the same place 
as employees after their instruction period is over. 
Being familiar with the shop's practice they are worth 
more to it than to another establishment and, conversely, 
being more valuable as workers the employer can afford 
to pay them more wages than they could ordinarily earn 
elsewhere. In the second place, the employer can train 
the men in his own methods and to his own standards, 



THE NEW SCHOOLHOUSE 71 

and prepare workmen made as it were to order. For 
these two advantages employers are frequently willing 
to operate apprentice schools and pay the pupils wages 
during their non-productive period. 

In Great Britain no fees are paid to the employer for 
such training, and he is expected to pay the disabled 
men wages which will represent the net value — if any — 
of the men's labor in his establishment. The wages thus 
paid are deducted from the training allowance paid by 
the Ministry of Pensions. In Canada, in view of the 
very generous scale of pay and allowances, it is thought 
best that the man should not be paid wages. If the 
employer gives him anything, it is regarded in the light 
of a bonus and does not prejudice his remittances from 
the government. 

A modification of the system of training men by place- 
ment in factories consists in starting the course of re- 
education in a vocational school and completing it in 
an industrial establishment. Subjects of training fall 
within classifications as to elementary preparation, and 
most of them are represented to some degree in the indus- 
trial schools. For example, a man who requires training 
as a silver-plater may learn the general principles of elec- 
tricity in a school classroom and laboratory and then 
go out to a plating shop for training in the application 
of these principles in plating practice. 

It is this combination of school and factory training 
which promises the widest development in the future. 

One great advantage of having part or all of the train- 
ing done in a factory is that the work is practical in the 
highest degree, taking place as it does under actual pro- 
duction conditions. All that is purely theoretical or 
extraneous is eliminated. 



72 THE DISABLED SOLDIER 

This training on the apprentice system has reached 
its highest development in Canada, where the executive 
officer of the vocational work has been enthusiastic 
regarding its merits and has secured exceptionally suc- 
cessful results. The range of training possibilities is well 
exemplified by some selections from the list of occupa- 
tions for which disabled soldiers of the Canadian forces 
are now being re-educated: armature winding, harness 
fitting, tinsmi thing, saxophone playing, pneumatic tool 
repairing, inspection of castings, watch-making, fur work, 
dental mechanics, storage battery repairing, tailoring, 
telegraphy, meat cutting, bronze finishing, linotype or 
monotype operation , piano tuning, milling and assaying, 
bronze finishing, lense grinding, ornamental ironwork, 
precious stone cutting, lead glazing, photography, and 
so forth. 

A typical school of re-education is the National Insti- 
tute for War Invalids, at Saint-Maurice, near Paris. This 
is a combination of an orthopedic hospital and a training 
center. It is under the joint control of the Ministries of 
War and of the Interior, the former administering the 
medical activities, and the latter the re-educational work. 

The soldier remains under charge of the War Depart- 
ment until medical treatment is completed, and the 
necessary prosthetic apparatus provided. He is then 
discharged from the army and passes under the jurisdic- 
tion of the Ministry of the Interior. 

The military hospital, containing seven hundred beds, 
is equipped for all kinds of medical and surgical work. 

The prosthetic division consists of five shops. In one 
is tested the apparatus supplied by private concerns ; in 
the other four, orthopedic appliances and prostheses are 



THE NEW SCHOOLHOUSE 73 

manufactured by workers whose services have been 
commandeered by the Ministr>^ of War. 

The hospital and the school operate conjointly. In 
many instances the trade training begins while the 
patient is still undergoing treatment. 

The trades taught at the Institute are shoemaking, 
tailoring, tinsmithing, and harness-making. There is also 
a commercial section, which includes courses in primary 
instruction, in commercial bookkeeping, and drafting. 
Finally, there is a special department where the men are 
taught to operate and repair tractors, agricultural ma- 
chinery, and automobiles. 

The men are lodged and boarded at the Institute. 
The dormitories can accommodate three hundred pupils ; 
in addition, seventy-five beds in the hospital are reserved 
for men under training in the workshops. 

One-armed men are not, as a general rule, directed 
into industrial pursuits. In exceptional cases, however, 
former agricultural workers are taught tractor operation. 
Whenever suitable, men with arm injuries or amputa- 
tions are given instruction in drafting or in commercial 
subjects. 

One of the principles of the school is to make the period 
of apprenticeship as short as possible. Dr. Bourrillon 
estimates that the time required to give an adequate 
training is four months for a bookkeeper, six months 
for a tinsmith, eight months for a shoemaker or agricul- 
tural mechanic, ten months for a harness-maker, and a 
year for primary instruction of an illiterate or for indus- 
trial design. 

The most popular workroom in the school is the shoe- 
making shop, the number of pupils averaging sixty. Most 
of the men attending this course are one-legged or legless. 



74 THE DISABLED SOLDIER 

Half of them are farmers who intend to return to their 
homes. A month's training is allowed for plain machine 
stitching, seaming welting, and soling. At the end of 
five months, the men should be able to re-sole shoes, 
both pegged and hand-sewed. Complete shoes are made 
by men of average ability after eight months. 

The tailoring department was not successful. The 
minimum apprenticeship of one year the men considered 
too long, and there were but few willing to undertake it. 
Instruction in this trade was therefore discontinued. 

In the harness-making shop, all branches of the trade 
are taught, though the greater part of the business is 
repair work. As by-products, the shop turns out small 
leather articles, such as pocketbooks and cigarette cases. 

The metal work shop turns ou^t fireless cookers, army 
canteens, and small tin articles. The men are taught 
sufficient of pattern work, soldering, and joining to 
become journeymen in the trade. 

The department of farm mechanics, which include 
tractor operating and repairing, is considered as one of 
the most important, in view of the great demand for 
agricultural machinery expected after the war on account 
of the shortage of labor. A number of graduates have 
been placed, either on farms or as demonstrators with 
firms which sell agricultural equipment. 

The drafting department comprises two sections, me- 
chanical and architectural. Arm injuries predominate 
in this department; many of the students are one- 
armed. There is great variety in the former occupations 
of the men; alongside of five draftsmen who had lost 
their right arm and were learning to do left-handed 
work were found nine machinists, one butcher, one chair- 
maker, one sausage-maker, one cook, three peasants, 



THE NEW SCHOOLHOUSE 75 

three cabinet-makers, two commercial clerks, one en- 
graver, five masons, one seaman, t\\'o joiners, one meter 
inspector, two electricians, one moulder, one building 
worker, one house painter, one sculptor, three locksmiths, 
one stone-cutter, and one without trade. 

The course in accounting shares popularity with shoe- 
making. The number of appUcations for this course is 
so large that it has been found necessary to confine ad- 
mission to men injured in the arm and men formerly 
employed in commerce; the latter make thirty-six per 
cent, of the pupils. Among the others are found a con- 
siderable number of former pea^nts — about twenty 
per cent. — and miners, masons, lathe-workers, printers, 
basket-makers, laundry hands, and so on. 

The pupils are free in choosing their trade; they are 
free also to change to another trade if the first choice 
has proved unsatisfactory-. They may also leave school 
at any time they desire. DiscipHne has been reduced to 
the minimum, and every unnecessary limitation upon 
the freedom of the pupils has been eliminated. 

The administration makes it clear, however, that the 
Institute is a place for work and study rather than an 
asylum home; it reserves the right to dismiss any man 
who does not work with sufficient industry to learn a 
trade in a reasonable time. 

So long as the product of his labor cannot be disposed 
of, each pupil receives a wage of fifty centimes a day. 
When the product is sold, the man receives his part of 
the profit realized, one-half being paid to him in cash 
fortnightly and the balance deposited to his credit until 
discharge, when he receives his accumulated savings 
and sometimes, in addition, a grant in cash or a set of 
tools. 



76 THE DISABLED SOLDIER 

During the first two years of the operation of the 
Institute, the number of pupils admitted was 923, and 
the number of graduates 481. Of these, 398 were placed 
in employment by the Institute. 

In addition to the men who are trained at the Institute, 
others are assigned to various re-educational schools in 
Paris, or are placed as apprentices in private shops. In 
both cases, the training is supervised by the Institute. 

The Institute maintains a boarding annex in Paris 
for the pupils who are trained outside. If during the 
training the man receives sufficient wages, he may be 
required to pay one franc seventy centimes a day for 
his board. The man is not maintained at the annex if 
his earnings exceed four francs a day. 

By taking advantage of the facilities of outside schools 
and workshops, the Institute is enabled to provide 
for the men instruction in any trade. Experience has 
shown, however, that the best results are obtained when 
the men, while receiving training, are under direct super- 
vision of the administration of the Institute and not 
exposed to the varied temptations and distractions of 
the capital city. 

In Germany, one of the most important institutions is 
the Dusseldorf School for the wounded. It was created 
by the so-called Headquarters for Voluntary Relief, an 
organization which had been formed for war relief in 
general, by amalgamating the interests of the local Red 
Cross, the Women's Patriotic League, and the city 
administration. 

The first step in re-educational work was the creation 
of a department of vocational advice for wounded soldiers 
under treatment in the fifty military hospitals of the city, 
which is a hospital center for the Rhine province. The 



THE NEW S C H O O L H O U S E / / 

vocational advisers come in touch with the wounded man 
at the early stage of convalescence, when there is greatest 
danger of the onset of mental letha^g>^ 

In February, 1915, about twenty general educational 
courses were started in one of the city's school buildings. 
Later, new and more suitable buildings were erected and 
equipped with machinery- and tools. Technical courses 
training for many trades were instituted, and provision 
made for the maintenance of the pupils and for allow- 
ances to their families. 

The various courses prepare men for employment as 
metal workers, engineers, telegraphers, electricians, car- 
penters, cabinet-makers and wood-workers, workers in 
the building trades, locksmiths, sculptors, stone-cutters, 
paper-hangers and plasterers, printers, photographers 
and etchers, bookbinders, cardboard and leather workers, 
dental mechanics, farmers, civil service employees, sten- 
ographers, and office workers. The trade courses prepare 
for the master-workers' examinations which can be taken 
at the Diisseldorf Board of Trade. Time spent at the 
school counts as time spent as a journeyman's apprentice. 
Examination fees have been waived for disabled soldiers. 
Also, instead of offering a pretentious sample of work as 
a * 'masterpiece," the would-be master worker simply has 
to prove that he can do what is required of a first-class 
workman in the particular trade. The Board of Trade 
has provided for a special tradeworkers' course in pre- 
paration for the examinations. 

As a general rule, it is aimed to restore ever>^ man to 
his former occupation. When physical disability pre- 
cludes this program, the object is to prepare him for 
some other position in the same line, usually for one that 
requires less physical but more intellectual effort. The 



/8 THE DISABLED SOLDIER 

program of Instruction includes, therefore, in addition to 
the practical trade courses and shop work, ample provi- 
sion, for theoretical training. 

The courses preparing for ofifice positions are the 
most popular with the disabled men, in Diisseldorf as 
elsewhere. An effort is made, however, to keep trade 
workers from turning to office work. The tendency is 
to reserve the clerical courses for men who formerly held 
minor government positions and who wish to prepare for 
civil service examinations, or for those who are too 
severely injured to perform physical labor, and especially 
for former traveling salesmen and sales clerks who by 
reason of their injuries must seek office jobs, preferably 
in their old line of business. 

Finally there is the department of general education, 
which teaches civics, rhetoric and grammar, and simple 
manual training, preparatory to more intensive voca- 
tional work later to be undertaken. There is also pro- 
vision for training the left hand of men who have lost 
their right hand or arm, and it has been found that a 
five weeks' course is sufficient to give these men a free 
and characteristic handwriting. In this work the one- 
armed pupils are taught by similarly handicapped 
instructors. 

In the Diisseldorf school sports and games play a r61e 
of considerable importance — not only recreational but 
curative as well. By three months of swimming practice 
one of the pupils recovered the entire use of a paralyzed 
forearm. 

When training is completed, the soldier is ready for 
useful and remunerative employment — to realize upon 
the values created during re-education. 



ATWORKAGAIN 79 



CHAPTER VI 

AT WORK AGAIN 

The real measure of success in putting the disabled man 
back on his feet is his showing on entry into regular 
employment. In matter of fact, the training is really 
the preliminary part of the placement program, inasmuch 
as the original choice of subject was made with reference 
to a definite labor demand, and the instruction largely 
determined by the employment requirements of the job 
in prospect. 

The finding of jobs for men trained in skilled trades is 
a comparatively simple matter, and it will be found that 
the good trade school usually has its pupils placed before 
their course is completed. So with the schools of re- 
education, the men are often taken away prior to gradu- 
ation. The heads of such schools are closely in touch 
with industry and, in a very informal way, keep on the 
lookout for good openings for their pupils. 

The men trained wholly or partly in factories are 
usually kept on by the employer with whom they are 
placed. There is thus no necessity of finding them a job. 

As has been pointed out, not all disabled men are dis- 
qualified from return to their former jobs, and thus many 
do not become candidates for re-education. As soon as 
hospital treatment is completed, they are ready to return 
to work. In the majority of instances they go back to 
their former job. On a questionnaire filled out by em- 
ployers in one of the Canadian provinces it was asked 
whether former employees who were disabled at the 



80 THE DISABLED SOLDIER 

front could count on the jobs which they left upon 
enlistment. The answers were emphatically in the 
affirmative: * 'absolutely/' or ''surest thing you know/* 
"you bet/' and more of the same character. The patri- 
otic motive in this case can safely be availed of, because 
the best placement possible is to return a man to an 
employer who knows him well, and to a job with which 
he is both satisfied and familiar. 

In Australia one of the first moves by the repatriation 
authorities after the return of the soldier is to communi- 
cate with his last employer, stating the man's disability 
and asking whether his old position is open for him, and 
In the event that he is disqualified for that job, whether 
there is another into which he can be fitted. Enlistment 
in the Australian Commonwealth was and has remained 
entirely voluntary. As one inducement to joining the 
forces many employers promised to hold jobs open for 
men until their return from the front. In many cases 
this was regarded as almost a contractual obligation; 
the man went to France or Gallipoli to fight for interests 
in which his employer shared; the latter agreed that 
the enlisted man should not lose his place through 
following the course of duty. So keen was the feeling 
regarding this reciprocal responsibility that there were 
even discussions in Parliament as to whether employers 
should be required by law to make good their promises. 
It was pointed out, quite logically, that there was usually 
no written evidence of the promise; that the employer 
worth working for would live up to his word, and that 
in the case of any other the man would profit by finding 
another job. The authorities have, however, secured the 
cooperation of chambers of commerce in registering offi- 
cially employers' commitments in this regard. 




1 



C3 



^ 



1^ 
^3 *^ 






AT WORK AGAIN 81 

The jobs of some of the disabled men who can return 
to their former occupation will, however, have disap- 
peared, due to suspension of operation, business failure, 
and other causes. The placement in these instances is 
comparatively simple, for the only necessity is to find 
the man a similar job. 

Still other men, however, who remain handicapped 
economically have not had or do not take advantage of 
re-educational opportunities. For such every resource of 
skilled employment technique is called into play. 

One of the most difficult tasks in the placement of 
disabled soldiers is to prevent their exploitation by em- 
ployers who might argue that, as the man is in receipt 
of a regular pension from the government, he can afford 
to take a job at a reduced wage. If a man has been fitted 
competently to hold down a given position, this conten- 
tion is indefensible, and is contrary to the whole theory 
of rehabilitation. As he should not receive wages in 
excess of his earning power, so his pay must not be prej- 
udiced because he has some outside source of income. 
The employer must not be permitted to regard the dis- 
abled man as a source of labor which can afford to work 
cheap. 

This tendency may be manifested not only in the 
original wages arrangement, but also in failure to in- 
crease wages in pace with augmented skill and produc- 
tivity, the employer imagining that the handicapped 
man will be loath to leave a job on the earnings of which 
— together with his pension — he can comfortably live. 
When the employment authorities are satisfied that such 
a situation prevails, the man should be immediately 
recalled and placed in another job. 



82 THE DISABLED SOLDIER 

There are many men, however, who can obtain em- 
ployment in the regular channels of industry but who, 
even when fully paid for the work they perform, cannot 
earn the standard wage. In order to assure that such 
men are not overpaid on the one hand, nor exploited on 
the other, there have been set up in several countries, 
advisory wages boards, which assess the earning capacity 
in individual cases. These boards are usually composed 
of an equal number of representatives of labor and capi- 
tal with one disinterested party to act as chairman and 
are appointed by authority. 

This question is regarded as of the greatest importance, 
of course, in the countries with minimum wage laws, and 
the unions have been solicitous to safeguard any invasion 
of the minimum wage protection which they won at so 
great pains. In New Zealand reduced rate permits are 
issued by the Returned Soldiers* Information Depart- 
ment, allowing a man to accept employment at less than 
the standard wage. In Australia the unions have stipu- 
lated that no more than one disabled man at a reduced 
wage to every six full-paid journeymen shall be employed 
in any given establishment. 

The trade unionists have quite properly watched the 
rehabilitation activities to see that disabled soldiers were 
not used to break down wage standards or, half-trained 
in some of the skilled trades, utiHzed as strike-breakers. 
Both apprehensions had some foundation in fact in the 
inexperienced and blundering days when the work first 
began. In one city, for example, a large class of motion 
picture operators was trained in a short course which 
did not adequately prepare them for the occupation they 
were to follow. When the members of this class sought 
employment, they offered to work for less wages than the 



W O R K A G A I X 83 



regular operatives, and succeeded in displacing some of 
the latter from their jobs. This caused a s^nke, and all 
the class found work in the moving picture theatres. 
But their incumbency was short-lived, for short-circuits, 
fires, and other accidents, natural to inexperience, decided 
the strike and returned the old operators to the jobs. 
The incident showed up some possibilities which boded 
ill to the labor men. 

Fortunately the rehabilitation workers have seen the 
danger of slipshod training and exploitation in employ- 
ment and have done everything possible to guard against 
them. In most instances the definite assistance and co- 
operation of organized labor have been secured, and labor 
has been given representation in the training and employ- 
ment activities. 

Samuel Gompers, president of the American Federa- 
tion of Labor, has made the following statement on the 
attitude of the trade unionists: 

Organized labor is wholeheartedly with the purpose of helping 
disabled soldiers and sailors to cany on as self-reliant, produc- 
tive members of socierv'. To men who have risked their lives 
for this Republic, we owe it s a duty to protect against depen- 
dency and the deteriorating consequences of lack of vocational 
training. 

Labor is concerned as to the rehabilitation of disabled soldiers 
and sailors not only for humanitarian social reasons but because 
of the detrimental economic consequences that would result 
from failure to return these men a^ resourceful, able members 
of society, restored in purpose and in skill. 

Labor desires to help in providing proper facilities under 
ci\*ilian control for the training of these men as well as to co- 
operate in returning them to industr>', agriculture, and com- 
merce where they can perform real service under such conditions 



84 THE DISABLED SOLDIER 

as will safeguard their best interests as well as those of fellow 
workers. 

Labor fully appreciates the value of the principles of freedom 
involved in this war and desires to do everything within its 
power to assure justice to those who render service to the cause. 

One of the leading labor authorities in Great Britain, 
G. J. Wardle, a member of Parliament, states that the 
Labor Party strongly favors the opening up of every 
possible avenue of instruction, not only to disabled men 
who had no particular trade before they joined the 
colors, but also to those already trained whose wage- 
earning capacity can be increased by further instruction. 
"Subject to there being no diminution in the standard of 
living, or possibility of the disabled man being used to 
defeat the legitimate objects which the trade unions 
have in view'' there is not only sympathy with the 
cause, but a very definite desire to **assist the disabled 
man in every possible way to secure employment on 
remunerative work.'' 

The unions acknowledge a very definite responsibility 
to their own members who return disabled from the 
front, and have promised to do everything in their power 
to replace them in the industry or arrange for their re- 
education. The typographical union in Toronto has 
paid for the training of some of its own disabled mem- 
bers, formerly hand compositors, as typesetting machine 
operators. In France some syndicats or unions have 
organized schools of re-education. 

For the more helpless to whom is not possible employ- 
ment in factories or mercantile establishments either at 
a reduced or standard wage, there is possible work either 
in a special subsidized workshop or at home. In the 
special shop the work in general and certain operations 



ATWORKAGAIN 85 

in particular can be adapted to the limitations of the 
handicapped workers. If the capital expense and over- 
head are pubHcly or philanthropically defrayed, such an 
institution can, from the proceeds of its product, pay 
for wages and materials. 

An example of this type of organization is the Incor- 
porated Soldiers and Sailors Help Society which came 
into being in England at the close of the South African 
war to provide employment for disabled men. Its work 
was greatly enlarged in consequence of the European 
war, and a series of "Lord Roberts Workshops'* estab- 
lished in various British cities. The sale of product is 
based largely upon considerations as to source and 
manner of manufacture. 

Such an organization is most necessary and helpful; 
it is highly important, however, that men be admitted 
to it only as a last resort after every possibility of fitting 
for employment in regular channels has failed. The 
man who can be put to work under normal conditions 
should not be segregated with disabled men exclusively. 

The soldier disabled too seriously even for work in a 
special shop or factory should be returned to his own 
home if he has family or relatives prepared to take care 
of him, rather than sent to a home for incurables, to 
live out his life amidst a colony of unfortunates. If 
possible he should be provided with work which will 
keep him busy and provide some modest financial return, 
which will prove to the shut-in a great incentive and 
satisfaction. 

The case of the shut-in child or adult who has no 
work to occupy the hours of his long days is indeed 
hopeless. A worker in a New York City organization 
that is interested in the welfare of the crippled shut-in 



86 THE DISABLED SOLDIER 

child and adult tells of the case of a man sixty years old 
who was hit by a truck and suffered the amputation of 
both legs in consequence. His lot appeared desperate 
until a paper novelty company provided work for him 
that he could do at home. The first week the man earned 
three dollars — a fortune it seemed to him, for he had 
given up all hope of ever being a productive worker again. 
With ambition rekindled, he built a workbench for 
himself, and was able to do considerable work at glueing 
and pasting and increased his earning capacity little by 
little. He took especial pride in the fact that he could 
purchase sweets for his wife out of his earnings. 

Some fairly satisfactory forms of home work can be 
found if pains are taken in their selection, and there is 
some effort to secure the work from manufacturers. 
With a little simple training of the workers it may be 
possible to induce the sending out of work not ordinarily 
so handled. There is necessary, of course, organization 
to obtain the work, transport it to the worker, check 
the quality of the workmanship, return the product to 
the manufacturer, bargain for rates of pay, and effect 
financial settlement. 

Some of the most successful subjects of home work 
already found in very limited civilian experience in seek- 
ing occupation for cripples of both sexes are toy painting 
and finishing, powder puff making, glove manufacturing 
and trimming, preparation of paint and varnish samples, 
tag and label stringing, paper novelty work, brush- 
making, and apron stitching and finishing. It is Hkely 
that many more satisfactory can be discovered. 

Many a disabled soldier whose thoughts never turned 
to a life in the open may be tempted, by the inducements 
held out by his government, to settle on the land. A 



A T W O R K A G A I N 87 

free homestead, a generous loan of money on easy pay- 
ments, a set of implements for his new occupation — 
these offers may open new vistas to the ex-soldier whose 
work, before the war, kept him in the factory or in the 
office. 

Thus, in France, a law was recently passed providing 
that disabled soldiers may be granted loans up to ten 
thousand francs, at an interest charge of one per cent, 
for the acquisition or improvement of small holdings. 

In England, it is planned to settle returned soldiers, 
in general, in large colonies of small holdings, to be 
created by the state. As an experiment of the practi- 
cability of this scheme, a Small Holding Colonies Act, 
passed in 1916, empowered the Board of Agriculture to 
acquire in England and Wales up to 6,000 acres of land, 
for the purpose of providing experimental small holding 
colonies. Scottish-American societies have established 
several garden settlements for men maimed in the 
war. 

Plans are also being made for an extensive settlement 
of returned British soldiers in the oversea dominions. 
To ascertain what facilities the dominions were prepared 
to offer in this regard. Sir Rider Haggard undertook in 
1916, on behalf of the Royal Colonial Institute, a journey 
throughout the dominions. In most of them the govern- 
ments declared their readiness to give the British soldiers 
the same facilities as regards settlement on land as the 
soldiers of their own military forces. 

The Canadian Soldier Settlement Act, passed last year, 
establishes a soldiers' settlement board which may 
recommend to the Minister of the Interior reservation 
of dominion crown lands. The minister may grant to 
discharged soldiers or sailors of Canada, the United 



88 THE DISABLED SOLDIER 

Kingdom, or any self-governing dominion free entry of 
not over 160 acres of this reserved land. An order-in- 
council has reserv^ed for the settlement of returned sol- 
diers all vacant and available dominion lands within 
fifteen miles on either side of railways in the districts 
where sufficient land is available for settlement on a 
large scale. The board may also grant loans not exceed- 
ing S2,500 to the settlers for the acquisition or improve- 
ment of land, the payment of incumbrances, erection of 
farm buildings, etc. The loans shall be at five per cent., 
and the principal shall be repaid in twenty annual instal- 
ments. Payment of the first two instalments may be 
deferred by the board. The loan is to be expended under 
the supervision of the board; it is granted in the form 
of warrants for expenditures, which are honored by the 
banks as checks. The board is authorized also to provide 
for the training of returned soldiers on farms, for the 
creation of agricultural training stations, for the appoint- 
ment of instructors and inspectors, and for training in 
domestic and household science for the settlers' wives. 

The Canadian Pacific Railway Company has also 
worked out a scheme for the settlement of returned 
soldiers on the lands which it owns in the western 
provinces of Canada. The settlement may be either on 
* 'improved farms'' in colonies selected by the company, 
or under an ''assisted colonization" system, where the 
settler selects his own land from any of the company's 
unsold land. The cost is to be repaid in twenty instal- 
ments, with interest at five per cent. 

In Australia the conference of the premiers of the 
several states in January, 1917, adopted a general plan 
which aims at settling on land 40,000 returned soldiers 
and sailors, Australian and British. The scheme is based 



ATWORKAGAIN 89 

upon the cooperation of the commonwealth and the 
states; the latter are to supply the land, since the crown 
lands are owned by the several states, and the former is 
to provide the necessary funds. The Federal govern- 
ment promised to raise £20,000,000 by loan, to be devoted 
to land settlement. Out of the Federal Fund, an advance 
of £500 for improvements may be made to the settler, 
on very easy repayment terms, the first annual instal- 
ment being of three and one-half per cent. only. The 
several states have enacted legislation to help the settle- 
ment of returned soldiers. New South Wales, which has 
over two million acres available, transfers the land to 
the soldiers for an annual five per cent, interest charge 
with one per cent, for amortization ; the total charge will 
be redeemed in thirty-eight years. The state may also 
advance to the settler £500, reserving the right to super- 
vise the expenditures, and provides for him also educa- 
tional and advisory aid. The state of Queensland has 
reserved all public lands for returned soldiers; there will 
be no rent charge for several years; then for twelve 
years the rent will be one and one-half per cent, of the 
capital value; later the rent charge will be fixed by 
rent-courts. Loans may be granted up to £500, at an 
initial rate of three and one-half per cent., gradually 
increasing to five per cent.; the loans are repayable in 
forty years. Other states, which have no public lands 
of sufficient fertility available must necessarily purchase 
land for soldier settlement. Thus in Tasmania the gov- 
ernment purchases large estates and divides them into 
small holdings; the money advanced by the common- 
wealth is used for improvements. The state government 
may also provide the settler with live stock to the value 
of £150 and with advances in cash up to £500 for build- 



90 THE DISABLED SOLDIER 

ings. All the sums expended are repaid in small annual 
instalments. 

In New Zealand, the Governor may from time to time 
reserve any area of crown land for the settlement of 
discharged soldiers. The holdings may be leased or sold 
to the applicants on terms decided upon by the Land 
Board; upon the recommendation of the latter, the 
Minister of Lands may also grant loans to the settlers. 

In Germany the periodical pension payments may be 
commuted to a lump payment to enable the disabled 
soldier to settle on the land and undertake farming. 
In Prussia, where the government has been active for 
twenty-five or thirty years in promoting the creation of 
small holdings, the disabled soldier can take advantage 
of the old legislation regarding the so-called ''rent-fee 
holdings'*; these are farms transferred to the settler, 
with the help of the state annuity-banks, against an 
annual rent charge redeemable in about sixty years. To 
help the settlement of disabled soldiers, similar legislation 
has been enacted during the war in some other German 
states, as in Bavaria and in the Duchy of Brunswick. 

In the United States the Secretary of the Interior is 
planning similar provision. As most of the desirable 
public lands have already been taken up, it is proposed 
to reclaim for soldier settlement territory which is now 
of no value, but which can be made fertile and productive. 

Historically, one of the most lucrative fields for the 
employment of the ex-soldier has been the public service, 
either by political appointment or under civil service 
control. After the Civil War one of the greatest handi- 
caps to the efficiency of national departments was the 
'Veteran preference'' legislatively enjoined, and many 
discharged soldiers received jobs for which they were 



AT WORK AGAIX 91 

not capable. Taking men into jobs on this basis is just 
another form of charity, and as this is now being dis- 
couraged on the part of private employers, so should 
it be reprehended on the part of the state. 

The civil service authorities should be asked, not to 
burden their list of appointments with men unfitted to 
the jobs in which they are placed, but merely to revise 
some of their rulings so as not to discriminate against 
the disabled as regards positions for which they are 
qualified. They may properly give preference to an ex- 
soldier when all other things are absolutely equal — but 
not otherwise. This is the fairest course toward the 
disabled applicants themselves. 

Many civil service commissions have, in the past, 
refused to permit crippled men to sit for any examina- 
tions, even when their disability would be no handicap 
whatever in the position sought. The one-legged but 
expert electrician has been barred from employment in 
the alarm division of the fire department; the one-armed 
cost accountant has been excluded from candidacy for 
an inside clerical job. Even in the national crisis of war 
it has been impossible for one highly skilled wireless 
operator, with a leg amputated, to gain employment in 
government service. If the authorities preach to indi- 
vidual employers an end of arbitrary and unjust dis- 
crimination against the disabled, the change in practice 
should begin at home. 

In France certain suitable posts in the government 
service or in enterprises benefiting by concessions from 
the state have been reserved for disabled soldiers. In 
Canada the returned man has preference in civil service 
appointments, and a great many of the re-educational 
classes prepare men for jobs in the revenue and postal 



92 THE DISABLED SOLDIER 

departments, so that the men may go to their work with 
preparation adequate to ensure success. 

After a disabled man has been placed in employment 
he should be followed up to see that the new relation is 
working out happily. The friendly visitor should inter- 
view both parties at interest: the employer to see in 
what ways, if any, the worker is not giving satisfaction ; 
and the employee to ascertain whether he considers he 
is being treated unfairly or not being given the best 
opportunity to make good. In the majority of instances 
the difficulties are not fundamental and may often be 
cleared up by a helpful third party, where the will to 
make the enterprise succeed is present on both sides. 

After disablement the first employment is a new ex- 
perience under strange conditions, and troubles either 
real or imaginary are liable to arise. Those of real sub- 
stance, such as unsuitability of an artificial limb, the 
lack of technical preparation for a certain process the 
worker is called on to perform, the misunderstanding 
on the part of a department head of the scope of work 
for which the man was employed, may be remedied in 
the appropriate manner. Those having their existence 
only in imagination are more difficult of adjustment. 
The deaf employee is sensitive and, not being able to 
hear the conversation of his fellow- workmen, becomes 
convinced they are criticizing and scheming against him. 
The blind man presents his perfected product to the 
taciturn foreman and interprets his silence or ambiguous 
grunt as dissatisfaction. In both these instances exactly 
the opposite situation may prevail, but it may require 
considerable tact in the demonstration. 

And lastly, where the job offers no fair remuneration 
for the present nor prospect for the future, or, from the 



AT WORK AGAIN 



man's point of view, is for other reason definitely un- 
satisfactory, the employment should be terminated at 
the advice of the visitor, and another placement made. 
An employment authority will often send men to jobs 
which are known not to be ideal, but the position should 
be regarded as temporary only and the worker recalled 
when better employment is available. On the other 
hand, where an employer — often with motives of good- 
will and helpfulness — has hired a disabled man on rep- 
resentation that he can competently meet the require- 
ments of the job, and it is found that the worker is failing 
to do so, or is careless, irresponsible, and not trying to 
do his duty, then he should be removed on the initiative 
of the same organization as made the placement, thus 
relieving the employer of the embarrassment of dis- 
charging a physically handicapped man. The general 
employment interest of the disabled will best be served 
by such a policy. This is particularly being recognized in 
relation to the blind, present placement plans providing 
for recall of the worker who is misplaced or failing to 
succeed. The average employer shrinks from discharging 
a blind man and may, even in spite of incompetence, 
carry him on the payroll for several years. But after 
one experience of this kind he will take good care indeed 
that he is not again saddled with a similar embarrass- 
ment in the person of another blind employee. 

Quite the antithesis of the policy of refitting the dis- 
abled man for return to the regular fields of industry to 
find employment side by side with normal workers — 
and with the disability assuming progressively a role of 
less and less importance — is a proposal recently made 
in England to provide for the partially disabled through 
the erection of a system of industrial villages wherein 



94 THE DISABLED SOLDIER 

should be housed and employed the returning physically 
handicapped soldiers. It being assumed that re-edu- 
cation has been provided for, there is proposed the 
creation of an exceptionally favorable environment so 
that the results of training *'may be increased a hundred- 
fold/' for it is argued that if the crippled men *'are 
compelled to carry on their work amid the evil condi- 
tions so often existing in our towns however well-housed 
in home and workshop, instead of in the villages which 
it is our desire and aim to see placed at the disposal of 
employers of wounded soldiers, as well as those who 
work at independent crafts, we shall certainly have failed, 
as a nation and individually, in our whole duty towards 
them.'* The proposal is to build up model villages, either 
now in their entirety or built around some existing 
nucleus. The financial suggestion is that the capital 
expenditure be financed at government or private ex- 
pense, but that beyond this point the disabled men 
should pay their own way. It is expected to provide a 
central business organization which would arrange for 
community purchase of supplies and marketing of 
products. 

Such a village, from the ideal point of view, would 
assuredly be a charming place in which to live. But 
whether the plan would work is open to some question. 
The best test of all proposals for disabled men is to con- 
sider whether they would work for normal men. On 
this criterion, it seems unlikely that a given group of 
men, mostly resident in large cities, could be persuaded 
in spite of apparent inducements to leave their present 
homes and social ties, and move with their families to 
a new locality. Certainly they would not do so unless 
satisfactory employment were certain indeed. 



AT WORK A G A I X 95 

It is proposed that the village be planned and built 
around a dominant industry-. By showing of actual ex- 
perience no industry' could be found which would suit 
any considerable proportion of disabled soldiers. The 
principles of their re-education call for training in the 
same line as that in which they were previously em- 
ployed or in a line ver>- closely related. The number of 
training subjects is constantly on the increase. For 
example, in Canada, disabled men are being taught 
ninety-seven different vocations. Xo village would 
supply employment of such wide range. 

It is on the social considerations involved, however, 
that must be taken most definite issue. The plan calls 
for the segregation of a special class, a policy which has 
been rejected in modern work of social character. In 
the statement of the plan this criticism is anticipated, 
and it is argued that disabled men will be happier in 
their own company than when struggling under real or 
imaginar\' odds against able-bodied competitors. The 
answer is that true happiness comes with replacement 
in normal employment, working side by side on an even 
footing with normal operatives. The aim of re-education 
is to turn out the soldier as a skilled worker in a job al 
li'hich his disability is jw handicap. Will the one-legged 
man be better off in a colony of cripples or — after thor- 
ough training as a telegrapher, monotype operator, or me- 
chanical draftsman — in employment secured through 
standard channels? 



96 THE DISABLED SOLDIER 



CHAPTER VII 

HELP OR HINDRANCE 

Though the re-educational provision may be excellent, 
and though the will and spirit of the men under training 
may be of the best, yet the complete success of a pro- 
gram of rehabilitation will depend upon whether the 
attitude of the public acts as a help or a hindrance — 
upon whether the influence on the individual ex-soldier 
of his family, his employer, and the community at large 
is constructive or demoralizing. 

What, then, is the public duty toward the disabled 
soldier? For it is certain that the requirements need 
only to be understood to be fulfilled. 

The first responsibility on the part of the family of 
the injured man is to learn the meaning of disability, 
and see the hopeful rather than the depressing aspect. 
Just recently, in the suburb of a large Pennsylvania city, 
a woman in a swoon was found on the steps of the local 
postofiice. She had just opened a letter from her son 
at the front which told of a gunshot injury necessitating 
amputation of his left arm below the elbow. Imme- 
diately there rose before her eyes the terrifying prospect 
of a life of idleness and possible pauperism. One can 
imagine what her next letter would be like: saying she 
knows what the amputation means and sympathizes 
most tenderly on account of what must be faced in the 
future. If it were only a leg, it would not be so bad for 
then he might be able to take care of himself and get 
some kind of a job, but with an arm off he could not 



1 



HELP OR HINDRANCE 97 

expect to do that. But she and father have saved up 
some, and with uncle's help they will take care of him 
till the end of his days. Picture the influence of this 
message in comparison with another which might be 
sent in the light of a fuller understanding of what is 
possible: '*I have just heard of your arm amputation 
and sympathize most lovingly in your loss. But I 
know you will not lose your courage, even at this sacrifice 
for your country. Even now, the national authorities 
are making plans to make up so far as possible for such 
losses, as you doubtless already well know. One-armed 
men can be trained for skilled jobs, especially men with 
native ability such as yours, and the training is already 
under way in the city near us. The employers also 
here are becoming tremendously interested in the sub- 
ject, are finding jobs specially suited to men who have 
lost arms or legs, and have promised these jobs to the 
fellows who return from the front disabled. And you 
can count on our standing behind you at every step and 
helping in every way we can. This is really a fine future 
to look ahead to, for if you make good here at home with 
your handicap of honor, you and we will have true 
reason to be proud. And of course you will succeed if 
you go at this obstacle with the same spirit and nerve as 
have gone toward your work in the army. Your mother 
will look forward to seeing you return home, wearing the 
uniform of Uncle Sam and flying the colors of a soldier 
who can't be beaten.'* 

It is greatly to be desired that the families of men 
going to the front should know of the possibilities of 
re-education and re-employment and of the provision 
being made for the disabled, for it would mitigate not 
only a great deal of mental suffering over actual injuries 



98 THE DISABLED SOLDIER 

but over prospective disabilities as well. It is well 
known that the greatest fear regarding service in the 
trenches is not the loss of life but the prospect of return- 
ing crippled. As one writer has well put it: **To die 
for one's country; if one could only be sure of dying!" 
In coming down in the elevator of a large New York 
department store recently, the day following the pub- 
lication in its pictorial section by a great daily newspaper 
of the photograph of the first American amputation 
cases in France, the following remark was overheard: 
*'Did you see those horrible pictures in the paper yester- 
day? I do hope that Jack will not come home that way; 
I would rather he be killed.*' Yet the picture showed 
only foot amputations, and to one familiar with cripples 
and their potential accomplishments such a disability 
seems a real inconvenience but nothing more. The 
woman quoted was suffering unduly in her apprehension. 

It is not here intended to minimize the seriousness of 
the total disabilities, but these occur in but one case in 
a hundred thousand. The point is that many injuries 
that might be regarded as terrible under unintelligent 
handling in the past no longer remain so. 

The second responsibility of the family is to under- 
stand the importance to the disabled soldier of the prof- 
fered training for self-support, and to encourage him 
in every possible way to undertake it. The family must 
do more than avoid opposition to the soldier's plan for 
re-education ; they must do more than give it lukewarm 
assent — they must get behind it with every influence at 
their command. 

Failure to have the family understand and support 
the program for the future of the disabled man may 
have disastrous results. In France the mother occupies 



HELP OR HINDRANCE 99 

an unusual place of authority in the family economy. 
A son may grow up to be twenty, thirty, or forty years 
old, but mother is still a chief to whom obedience is un- 
questionably paid. In dealing with the poilu, therefore, 
one must count on his maternal parent as well. At one 
French center of hospital care and re-education it was 
found that as a man would approach the point of his 
medical recovery and approach the time of entry on 
vocational training, his mother was liable to descend 
upon the hospital office, beat her umbrella on the table, 
inquire why they were keeping her son so long away 
from home, and demand his immediate discharge in 
order that she might take him away *'to care for the 
poor crippled boy for the rest of his life.'* In vain were 
explanations and arguments regarding the efficacy of 
further treatment and training. She had come there 
determined to take her son away, and the scene would 
continue until her end was accomplished. And in most 
instances there was nothing to do but accede to the 
mother's demand. 

But a better way was found of dealing with the 
families of men deemed likely to benefit by re-education. 
Under this procedure, when the soldier was nearing the 
end of his hospital care, the director of the institution 
would summon the mother to come in and advise re- 
garding her son's future. She would then be addressed 
something in this wise: ^'Your son's medical treatment 
will in another week or two be practically complete, 
and we thought you might like to know so that, if you 
desired, you could make plans to take him home. But 
you know he is permanently disabled and will not be 
able to go back to his old job of telegraph lineman. We 
know that you expect to care for him, but he will outlive 



100 THE DISABLED SOLDIER 

you, and later, since the government pension is small 
indeed, he will be reduced to a miserable situation. You 
remember the cripples from the war of 1870, how they 
begged or sold trinkets about the streets — and you 
would not want your son to be in that fix. Luckily, 
however, he will not have to be for we have something 
else to suggest. Across the street is a school where the 
men are taught various skilled trades. If your son 
cares to stay for five or six months, and you approve, 
we will teach him to be a telegrapher and he can go back 
to his home town and get a good job with the govern- 
ment telegraphs. As a skilled worker still he will be 
doubly respected in the community, he will be a burden 
on no one, his future will be assured, and you will be 
very, very proud of him. What do you think wise 
under the circumstances?'* 

The whole situation is changed. Mother greets her 
boy with: *'Son, have you heard what they are going to 
do for you?'* And as the son has already been talked 
to regarding the program, the joint decision is assured. 

This illustrates the difference between a family for 
or a family against the proposal of re-education. 

The third duty of the family is to stand behind the 
man during his course of training and try in every way 
to encourage rather than dishearten him. Letters from 
home which recite all the troubles of life and none of 
the joys will not help the enterprise. The family re- 
action should rather be: **Stick to it; we are getting 
along all right and want to see you finish the job up 
right, now that you are at it." In other words, it is 
necessary to maintain the morale of the family in the 
same way as when the man is at the front. This is 
largely contributed to by home visitors such as those 



HELP OR HINDRANCE 101 

of the Canadian Patriotic Fund or the American Red 
Cross. 

The fourth family responsibihty toward the disabled 
man is to make the home influence as sensible and as 
truly helpful as possible after his return from hospital 
or school. The first and very natural impulse when son 
or husband comes home crippled or blind is to pet him 
and wait on him hand and foot. Yet the best interests 
of the family as well as of the man himself demand his 
being encouraged to do for himself everything he can, 
with the aim of stimulating that self-dependence which 
has been the object of his whole course of training. 
Within the limits imposed by affection the family 
should endeavor to carry along the spirit of that training. 

In the readjustment of the crippled soldier to civilian 
life the employer has a very definite responsibility. But 
this duty is not entirely obvious. It is, on the contrary, 
almost diametrically opposite to what one might super- 
ficially infer it to be. The duty is not to *'take care of," 
from patriotic motives, a given number of disabled men, 
finding for them any odd jobs which are available, and 
putting the ex-soldiers in them without much regard to 
whether they can earn the wages paid or not. 

Yet this method is all too common. A local committee 
of employers w^ill deliberate about as follows: ''Here 
are a dozen crippled soldiers for whom we must find 
jobs. Jones, you have a large factory; you should be 
able to take care of six of them. Brown, can you not 
find places for four of them in your warehouse? And 
Smith, you ought to place at least a couple in your 
store." 

Such a procedure cannot have other than pernicious 
results. In the first years of war the spirit of patriotism 



102 THE DISABLED SOLDIER 

runs high, but experience has shown that men placed 
on this basis alone find themselves out of a job after the 
war has been over several years, or in fact, after it has 
been in progress for a considerable period of time. 

A second weakness in this method is that a man who 
is patronized by giving him a charity job, comes to 
expect as a right such semi-gratuitous support. Such 
a situation breaks down rather than builds up character, 
and makes the man progressively a weaker rather than 
a stronger member of the community. 

The third difficulty is that such a system does not 
take into account the man*s future. Casual placement 
means employment either in a make-shift job as watch- 
man or elevator operator — such as we should certainly 
not offer our disabled men except as a last resort — or 
in a job beyond the man, one in which, on the cold- 
blooded considerations of product and wages, he cannot 
hold his own. Jobs of the first type have for the worker 
a future of monotony and discouragement. Jobs of the 
second type are frequently disastrous, for in them a man, 
instead of becoming steadily more competent and build- 
ing up confidence in himself, stands still as regards im- 
provement and loses confidence every day. When he is 
dropped or goes to some other employment, the job will 
have had for him no permanent benefit. 

Twelve men sent to twelve jobs may all be seriously 
misplaced, while the same twelve placed with thought 
and wisdom and differently assigned to the same twelve 
jobs may be ideally located. If normal workers require 
expert and careful placement, crippled candidates for 
employment require it even more. 

The positive desideratum is to find for the disabled 
man a constructive job which he can hold on the basis 



HELP OR HINDRANCE 103 

of competence alone. In such a job he can be self- 
respecting, be happy, and look forward to a future. 
This is a duty not so easy of execution as telling a super- 
intendent to take care of four men, but there is in- 
finitely more satisfaction to the employer in the results, 
and infinitely greater advantage to the employee. And 
it is entirely practical, even in dealing with seriously 
disabled men. 

Thousands of cripples are now holding important jobs 
in the industrial world. But they are men of exceptional 
character and initiative and have, in general, made their 
way in spite of employers rather than because of them. 
Too many employers are ready to give the cripple alms, 
but not willing to expend the thought necessary to place 
him in a suitable job. This attitude has helped to make 
many cripples dependent. With new responsibilities to 
the disabled soldier, the point of view must certainly be 
changed. What some cripples have done, other cripples 
can do — if only given an even chance. 

This, then, constitutes the charge of patriotic dut}^ 
upon the employer: 

To study the jobs under his jurisdiction to determine 
what ones might be satisfactorily held by cripples. To 
give the cripples preference for these jobs. To consider 
thoughtfully the applications of disabled men for em- 
ployment, bearing in mind the importance of utilizing 
to as great an extent as possible labor which would 
otherwise be unproductive. To do the returned soldier 
the honor of offering him real employment, rather than 
proffering him the ignominy of a charity job. 

The responsibility to the disabled soldier on the part 
of the community at large is much more complex, since 
the contact exists at a multitude of points and is at 



104 THE DISABLED SOLDIER 

none highly Intimate. The first reaction of the pubHc 
to the returning man is hero-worship of the most empty 
type — described coldly, it usually consists in making a 
fool of the man and entertaining him in inappropriate 
and hurtful ways. 

One form of this is society lionization — and for but 
the proverbial six days indeed. To a large Canadian 
city there returned a disabled soldier after two years* 
absence at the front. His wife and children had been 
looking forward expectantly to having him with them, 
but after his arrival saw but little of the head of the 
house. As a national holiday was approaching, they 
were counting on his accompanying them to the park, 
and had exacted a tentative promise that he would do 
so. But as the morning arrived and mother was dressing 
the children to start, father made no move to get ready. 
Almost tearfully mother asked if he was not going with 
them. ''Oh, no,'' he answered, "I am going for an auto- 
mobile ride this morning and this afternoon to a sing- 
song at the [naming a fashionable hotel]." This 

was the way in which the community was showing kind- 
ness to the returned soldier and helping to put him back 
on his feet! 

The man on the street thinks the greatest service to 
the disabled fighter, particularly when he is discharged 
from the army and no longer under the partial protection 
of the khaki, to consist in buying him at the corner 
saloon as many drinks as he can hold. From one small 
American city a social worker reported inability to dis- 
tinguish as to whether certain 'discharged men were 
suffering from shell shock or intoxication, so hearty was 
the hospitality of the citizens. Such '^kindness" requires 
no comment. Fortunately the war-time measure regard- 



HELP OR HINDRANCE 105 

ing the liquor trade will soon make this impossible, and 
will guard the ex-soldier from one pitfall. It may be 
noted in passing that this will be a boon to the returned 
men in more ways than one. In Canada at a time when 
most of the provinces had prohibition and one or two 
others limited license, the placement of disabled men 
in employment was many times simpler in the dr>' ter- 
ritory than the wet. In the latter many men lost jobs 
again and again by reason of intoxication, not only in- 
juring themselves, but weakening the standing of their 
fellows as well in the eyes of the employers. 

Finally, there is the great general public prejudice 
against the disabled, the incredulity as to possible use- 
fulness, the apparent will to pauperize, and the reluc- 
tance through usual channels of opportunity to give the 
handicapped man a chance. Successful crippled and 
blind men unanimously testify that the handicap of 
public opinion is a greater obstacle than amputation of 
limb or loss of sight. And this unenlightened attitude 
is manifest in ever\^ social relation of the disabled — with 
family, with employer, with the community as a whole. 

It becomes clear, therefore, that a necessar>^ feature 
of any program for restoring the disabled soldier to 
self-respect and self-support is a campaign of public 
education to convert the general attitude toward the 
crippled and handicapped. 

This need was recognized most clearly among our 
enemies by Germany and among our allies by Canada. 
There was signal failure to appreciate the value of pubHc 
education in France, Great Britain, and Italy. There 
is no need of it yet in Belgium as all the disabled men 
are retained in the army and provided not only with 



106 THE DISABLED SOLDIER 

training but with employment as well, and there is no 
family problem as the men cannot return home. 

Within a few months of the opening of the war, the 
secretary of the German national federation for the aid 
of cripples made a tour of the leading cities of the 
Fatherland speaking to meetings of public officials, 
social workers, and the like, with the aim of disseminating 
intelligence regarding modern principles and methods 
of dealing with the disabled. The same authority pre- 
pared several pamphlets of popular character which 
were distributed in editions of over a hundred thousand. 
There was in existence at the outbreak of the war an 
excellent monthly journal on work for cripples, and this 
devoted its columns to the subject of provision for the 
war disabled. Some other special publications in the 
same field immediately sprang up. One of these has 
the interesting title of ''From War to Industry.*' 

There has been issued under the title of "The Will 
Prevails'* a volume of biographies of cripples who have 
overcome their handicaps — ^from Tamburlaine down to 
men disabled in the present war. The book is intended 
for circulation in hospitals and for general reading. 
Exhibitions illustrating in a practical way the possibili- 
ties of the war cripple constitute another vehicle of 
public education, and have been held in the leading 
centers of the empire. Moving pictures and lantern 
slides are also being utilized for propaganda to stimulate 
interest on the part of the people and to arouse ambition 
and courage on the part of the disabled themselves. 

In Canada a real and very intelligent effort has been 
made to acquaint the people with the aim and practice 
of re-education. A well-known poster, printed in red 
and black, entitled **What Every Disabled Soldier 



HELP OR HINDRANCE 107 

Should Know'' is widely in evidence throughout the 
Dominion. It is really addressed as much to the public 
as to the returned soldier. The text of the poster is as 
follows : 

That there is no such word as ''impossible" in his dictionary. 

That his natural ambition to earn a good living can be ful- 
filled. 

That he can either get rid of his disability or acquire a new 
ability to offset it. 

That the whole object of doctors, nurses^ and instructors is 
to help him in doing that very thing. 

That he must help them to help him. 

That he will have the most careful and effectual treatment 
known to science. 

That interesting and useful occupations form a most valuable 
part of the treatment in the convalescent homes and san- 
atoria. 

That if he cannot carry out his first duty by rejoining his 
comrades at the front, and if there is no light duty for him with 
the Canadian forces overseas, he is taken home to Canada, as 
soon as his condition and the shipping facilities make this 
possible. 

That his strength and earning capacity will be restored there 
to the highest degree possible, through the Invalided Soldiers' 
Commission. 

That if he requires an artificial limb or kindred appliance it 
will be supplied free. 

That every man disabled by service will receive a pension or 
gratuity in proportion to his disability. 

That if his disability prevents him from returning to his old 
work he will receive free training for a new occupation. 

That full consideration is given to his own capacity and de- 
sires when a new occupation has to be chosen. 

That his own will-power and determination will enable him 
to succeed, both in the training and in the occupation afterwards. 



108 THE DISABLED SOLDIER 

That his maintenance and that of his family will be paid for 
during the training he may receive after discharge, and for a 
month longer. 

That neither his treatment nor his training will cost him a 
cent. 

That his home Province has a special commission to assist 
him in finding employment on discharge. 

That hundreds of towns and villages have committees, asso- 
ciations, and clubs, to welcome him on arrival, and to help in 
securing a position for him. 

That the Dominion and Provincial governments, the munici- 
pal authorities, and all sorts of employers, give the returned 
soldier preference in filling vacant positions. 

That the returned soldier wishing to take up land and farm 
it, will be helped to do so, under Federal and other settlement 
schemes. 

That the Invalided Soldiers' Commission exists to carry out 
his restoration and training in Canada. 

That the Board of Pension Commissioners exists to distribute 
the pensions provided by his country for him and his dependents. 

That the Invalided Soldiers' Commission and the Board of 
Pensions Commissioners are in the position of trustees, appointed 
for his benefit, and representing the whole people of Canada, 

That, therefore, he should write direct to the commission or 
the board if he needs advice or help. 

Canadians are unanimously resolved that every returned soldier 
sJmll have a full opportunity to succeed. When that opportunity 
is put within his reach, his success will depend on his own good 
sense in seizing and using it. 

Another poster of pictorial character shows a one- 
armed man, fitted with an artificial appliance, at work 
on a drill press. 

The daily press has been supplied with material 
descriptive of the success of men who have completed 
training and made good. Some stories have carried 



I 



HELP OR HINDRANCE 109 

with them a Uttle preachment as to sound attitude 
toward the disabled soldiers. One concludes with this 
statement: ''Every man doing steady work suited to 
his capacity is a gain to himself and his country. Every 
man left idle, or performing some trifling task beneath 
his capacity, or trying to do work he is unfit for, is 
wasted. And Canada cannot afford to waste a man." 

A remarkable moving picture film in ten reels has been 
prepared by the government authorities to illustrate the 
progress of the disabled soldier after his return from 
overseas. It shows reception at the debarkation depot, 
transportation in a hospital train, various forms of treat- 
ment at military hospitals, recreation, vocational train- 
ing, and, finally, re-employment in industry. The mes- 
sage of the series of reels is ''that injury does not mean 
pauperism; that every man is given a chance to make 
good.'' Where the man does not try to help himself, 
however, there is shown the opposite eventuality of 
vagrancy. The film is for exhibition in Canadian mili- 
tary hospitals in England, and for showing to the public 
of the Dominion. 

In the United States there has been as keen if not a 
keener realization of the fundamental importance of 
public education to the cause of the disabled as in any 
other country, and as might properly be expected actual 
work on such a campaign began at an early date. The 
Surgeon General of the Army issued in October, 1917, 
a clear statement of the modern policy and spirit of 
dealing with the disabled soldier, under the title of **The 
Passing of the Cripple." Later the same office made an 
excellent contribution to the cause in the preparation of 
moving picture films of five successful American cripples, 
who were seriously handicapped, yet had overcome their 



110 THE DISABLED SOLDIER 

obstacles. This series of reels was entitled **The Way 
Out,'* and was intended for showing to the general public 
and in hospitals overseas to men who have just met with 
disabling injury. The set is one item in a * 'cheer-up 
campaign/' another projected feature of which is the 
issue of a volume of biographies of disabled Americans 
who have beaten their handicaps. Still another factor 
in this work is the issue by the Surgeon General, in co- 
operation with the American Red Cross of an inspiration 
magazine, by name ''Carry On/* which aims to convey to 
members of the Army medical corps, to Army nurses, to 
Red Cross home service workers, and to the public at 
large some conception of the new spirit in dealing with 
wounds, of more kinds than one, which are sustained at 
the front. This magazine has already a monthly circu- 
lation of over a hundred thousand. 

An unofficial campaign in the interest of the disabled 
was early initiated by the Red Cross Institute for Crip- 
pled and Disabled Men. One of the most familiar items 
in this campaign was a small folder of which over seven 
million copies were distributed, largely through the cour- 
tesy of telephone, gas, electric, and other public service 
corporations. It was entitled *'Your Duty to the War 
Cripple" and its text — which epitomizes the gospel 
preached in the campaign — read as follows: 

When the crippled soldier returns from the front, the govern- 
ment will provide for him, in addition to medical care, special 
training for self-support. 

But whether this will really put him back on his feet depends 
on what the public does to help or hinder, on whether the com- 
munity morally backs up the national program to put the dis- 
abled soldier beyond the need of charity. 

In the past, the attitude of the public has been a greater 
handicap to the cripple than his physical disability. People 



HELP OR HINDRANCE 111 

have assumed him to be helpless, and have, only too often, per- 
suaded him to become so. 

For the disabled soldier there has been ' 'hero-worship"; for 
the civilian cripple there has been a futile kind of sympathy. 
Both do a man more harm than good. 

All the cripple needs is the kind of job he is fitted for, and 
training in preparation for it. There are hundreds of seriously 
crippled men now holding down jobs of importance. Other 
cripples can do likewise, if given the chance. 

In the light of results already attained abroad in the training 
of disabled soldiers, the complete elimination of the dependent 
cripple has become a constructive and inspiring possibility. 

Idleness is the great calamity. Your service to the crippled 
man, therefore, is to find for him a good busy job, and encourage 
him to tackle it. 

Demand of the cripple that he get back in the work of the 
world, and you will find him only too ready to do so. 

For the cripple w^ho is occupied is, in truth, no longer handi- 
capped. 

Can the crippled soldier — or the industrial cripple as well — 
count on you as a true and sensible friend? 

The assistance of chambers of commerce and manu- 
facturers' associations was enlisted to secure transmittal 
to their members, with a special note of endorsement by 
the organization, of a circular calling to the attention 
of employers their responsibility to the disabled soldier. 
Over two hundred thousand employers were reached 
direct in this manner, and the statement was reprinted 
in scores of trade journals. 

A speaker's bureau was organized, a film and picture 
service instituted, and the daily press and magazines were 
supplied with informative articles on the vrork being 
accomplished abroad in the reconstruction of crippled 
men. One of the most interesting features of the work 



112 THE DISABLED SOLDIER 

was the preparation for individual trade journals of 
articles on re-education in the particular trade covered 
by each journal or on employment opportunities for 
the disabled in that trade. This material proved of very 
direct interest to both editors and readers of the journals. 

Another feature of the campaign was the issue of a 
booklet in ten foreign languages: Yiddish, French, 
Italian, German, Hungarian, Polish, Greek, Spanish, 
Danish, and Swedish. These were distributed to pastors 
of foreign language speaking congregations, and to phy- 
sicians and social workers in the foreign communities. 
The text of the booklets was also reprinted by almost 
every foreign language newspaper in the country. 

The work of public education in the interest of the 
cripple has just begun. It must be continued until the 
''man on the street*' is thoroughly familiar with his 
responsibilities to the disabled. 



HORS DE COMBAT 113 



CHAPTER VIII 

HORS DE COMBAT 

The disabilities of modern warfare are varied indeed. 
While the soldier with a leg off has represented in liter- 
ature and illustration the war disabled, this represen- 
tation is statistically far from accurate, and many other 
classes of handicap incurred in military service have 
numerically exceeded the amputated. Yet to the public 
at large the one-legged hero will doubtless continue to 
typify the toll of warfare in disability. 

By criteria of method and manner of treatment and 
training, certain groups of the disabled are set aside into 
classes from among the multitudinous list of causes for 
which men are discharged from the army. Into such 
clear classifications fall the blinded, the deafened, the shell 
shocked and other mental cases, and the tuberculous. 
These groups will be dealt with in succeeding chapters. 
Excepting cases of facial disfigurement, which is a subject 
in itself, there remain to be considered a wide variety of 
cases which can best be described as crippled, allowing 
for a liberal interpretation of that term. 

This class comprises amputations, paralyses, severe 
rheumatism, limitation of movement in joints due to 
gunshot injuries, general debility due to long-contin- 
ued suppuration, and a long list of other difificulties. 
Although medical treatment may vary, all may be con- 
sidered to require the same type training provision and 
employment. 



114 THE DISABLED SOLDIER 

It should particularly be noted that many of the most 
serious disabilities from the point of view of employment 
are not at first glance apparent. For example, a tour 
may be made of some Canadian centers of re-education 
without observing in the classes more than one or two 
obvious cripples. 

It is the crippled soldiers who will be discussed in the 
present chapter. For convenience the class will be still 
further sub-divided into amputation cases and other dis- 
abilities. 

The first requirement of the amputation case is an 
artificial limb. It is worthy of note that there has been 
a complete revolution in the surgical methods in leg 
amputations. No longer is a crippled man permitted to 
drag himself around for months on crutches, learning 
how to walk on his armpits and forgetting how to walk 
with his legs. One reason for this practice in the past 
was that it was impossible to fit the artificial limb until 
the stump had had a chance to shrink to something 
resembling its final form. But in the modern anxiety of 
the surgeons to get the man back on his legs, they do not 
wait for fitting of the permanent limb, but put on him 
at once, a few weeks after amputation, a temporary peg 
leg made of splints and plaster, or papier-mache, or of 
some other similar material. The soldier then leaves his 
bed and takes his first steps about the hospital. An 
appHance of the sort meets in a most satisfactory way 
all the requirements of transport from overseas. 

A peg leg of any kind, however, if worn for some length 
of time gets a man in a bad habit of walking, for the 
reason that it must be swung outward in a semi-circular 
motion to bring the foot of the peg from the end of one 
step to the beginning of the next. This process is known 




Learning to Walk for the Second Time. At Naples , 
Italy, crippled soldiers are provided with 
artificial limbs and taught to use them 




A *' Working Arm'' in lieu of Nature's Own. A variety of tools 
can he fitted into the chuck of this appliance^ and the one- 
armed poilu is again enrolled in the army of labor 



HORS DE COMBAT 115 

scientifically as abduction. In providing for leg ampu- 
tations among men in the American Expeditionary Force, 
after the cases have been returned to this country, 
another improvement has therefore been made. Tem- 
porary limbs of hollow fiber, made with knee and ankle 
joints in practically the same manner as the final leg, 
are made up in standard units in sufficient numbers to 
meet the probable demand. These are fitted to the men 
after they have worn the peg leg for a short time, and 
the fitting can be changed as the stump alters in shape 
or size. This provisional leg is expected to last from 
six months to a year and to serve satisfactorily, therefore, 
until the permanent limb can be fitted with the best 
results. 

France and Great Britain were caught unprepared by 
the demand for limbs, as their supply had been before 
the war largely imported from Germany. They have 
had to make strenuous efforts to meet their needs. 

Most of the countries purchase their limbs from private 
manufacturers. At Roehampton, the great limb-fitting 
center in England, individual manufacturers have been 
permitted to erect shops on the grounds of the hospital. 
Canada led the way in the establishment of a government 
limb factory, though many of the parts used were, 
during the first year or two of operation, purchased from 
outside concerns. More recently Australia has estab- 
lished an artificial limb shop, which is now operated by 
the Minister of Defense, but is to be handed over at the 
conclusion of the war to the Repatriation Ministry. In 
the United States the purchase of permanent artificial 
limbs, which will be furnished free of charge to crippled 
soldiers, is in the hands of the Bureau of War Risk 
Insurance. 



116 THE DISABLED SOLDIER 

The most popular type of limb being made abroad is 
what is known as the "American leg/* This is made up 
from units of willow, first shaped for outside contour and 
then hollowed out in similar contour to reduce weight. 
The units are then covered with rawhide, varnished, and 
assembled with the joints, stops, and springs necessary 
to their proper functioning. 

In the field of artificial arms an American model has 
again had preference, though a very satisfactory but 
elaborate type has recently been worked out in France. 
These arms permit the performance of practically all the 
duties of every day life. 

In arms of this character movement is attained by 
linking up the mechanism by cables of wire or rawhide 
with new muscular combinations. Thus expiration of 
the chest may open the fingers, and movement of the 
opposite shoulder may operate the elbow. 

A still more modern development, the invention of an 
Italian surgeon by name Vanghetti, is what is known as 
kinematic amputation. By this method of operation 
tendons and muscles are so arranged that attachment 
may be made to them, and there may thus be caused 
direct movement of the artificial member. Very often, 
however, the action of a muscle will cause a different 
movement from that which it was accustomed to effect 
under natural conditions, and it then becomes necessary 
to re-educate the motor reactions in order to attain 
ordered control. The final value of this method has 
not yet been determined. 

One of the most interesting developments in dealing 
with cases of arm amputation is the fitting of industrial 
workers with mechanical appliances, designed to meet 
the requirements of their particular trades. Thus a 



HORSDE COMBAT 117 

bench machinist will be provided with a chuck which will 
hold interchangeably a file, hammer, chisel, or other tools. 
A drill press operator will have a hook or ring which will 
pull down the lever of his machine. An agricultural 
worker will be equipped with a cylindrical grip or grips 
which will slip over and hold the handles of various farm 
tools. A glass worker will have an appliance especially 
suited to the demands of that calling. Such apparatus 
do not displace the modern artificial arm which is also 
furnished to the arm cripple to use in his home on even- 
ings and Sundays. But it has been thought wise for 
specialized jobs to develop specialized appliances to 
perform them. 

Especial ingenuity has been devoted in France to the 
design of apparatus for agricultural workers in order to 
assist the effort to put back on the land just as many 
men as possible whose experience has been in farming. 
Even men with both arms amputated have been refit- 
ted for this work. 

There are other arm devices for general use which do 
not resemble arms. One is a universal hook which will 
perform a wide variety of tasks. Another, invented and 
developed by a man who is himself handicapped by 
double arm amputation, consists of a holder in which is 
a general utility hook which may be replaced by knife, 
fork, pen, or other tool or implement. This is one of the 
most practical appliances for a man with both arms 
off. 

While many of the most eminent engineers and ortho- 
pedic surgeons of Germany were engaged in the devel- 
opment of working arms for industrial or agricultural 
employees, the best and most practical model of all was 
produced by a simple peasant who had lost one of his 



118 THE DISABLED SOLDIER 

own arms in the war. The arm is named after him the 
"Keller Claw." 

For partial paralyses and other orthopedic difficulties 
not involving amputation all kinds of supports, braces, 
and the like, of great ingenuity and in wide variety, have 
been devised. 

The cases of crippling disability other than amputation 
require little comment in a book of this character, for 
they are treated according to standard methods of medi- 
cine and surgery. The most interesting new development 
is the advance in methods of ^Afunctional re-education"as 
it is called — the training of injured joints, muscles, and 
the like back to normal movement and capacity. This 
treatment is now active rather than passive, that is, the 
patient exercises himself rather than sits quiescent with 
the movement induced by external force. In one set of 
most interesting apparatus there is a dial on every piece 
so that the patient can see for himself what range of 
movement is attained and, as it were, compete with his 
own record at the preceding treatment. 

As regards trades suitable for cases of arm and leg 
amputation, there is accurately speaking no such classi- 
fication possible, because the future of each man must 
be determined by individual considerations. A trade 
which might be unwise for the great majority of arm 
cases might in an individual instance, by reason of the 
man's past experience, be the best one for him to under- 
take. There can be made a list of trades not possible to 
the amputated of various types, but the converse cannot 
so confidently be compiled. 

An approximation based on experience in re-educating 
arm or leg cripples can, however, be arrived at. Such is 
represented by a list issued by the British Ministry of 



HORS DE COMBAT 119 

Pensions. For leg amputations, among others, it lists: 
bootmaking, caretaker, chaufifeur, domestic service, elec- 
trical work, engineering, gateman, groom, hall porter, 
hospital orderly, industrial work (sundry forms), muni- 
tion work, milker, packer, painter, printing, railway work 
(varied), tailoring, telephone attendant, telegraphy, time- 
keeper, and watchman. For arm amputations it lists: 
clerical work, gymnastic instructor, messenger, porter, 
railway work (sundry duties), scholastic, telephone 
switchboard attendant, timekeeper, watchman. 

A few generalizations apply. A man with an artificial 
leg should not be prepared for a job which will keep him 
standing or walking more than one-third or one-half the 
time. A one-armed man, if his mental capacity permits, 
may most successfully be trained for a clerical or desk job. 

In the actual work with cripples there is no limit on 
originality, for each case practically entails a new eco- 
nomic plan. The worker in this field will discover new 
principles as he proceeds. There is also no limit to the 
fascination of the subject, for the field is still a frontier 
for pioneers and the satisfaction derived from putting one 
helpless man after another back on his feet is very real 
indeed. 



120 THE DISABLED SOLDIER 

CHAPTER IX 

OUT OF THE DARKNESS 

Blindness is a very serious handicap, the Intensity of 
which cannot be minimized. This is especially the case 
/With the loss of sight occurring in adult life as with the 
blinded soldier. With all his activities organized on a 
sighted basis, the new limitation seems crushing. Yet 
there is a way out of the darkness to happiness, and it is 
our sacred duty to help the blind veteran to find that road. 

This obligation has been well stated by Eugene Brieux, 
who has taken a deep interest in the war blinded of 
France. *Tor some wounded soldiers our responsibility 
IS over when their wounds are healed, but for the blind 
it then only begins. Blinded soldiers have been reduced 
to a state of disadvantage to other men; they have 
become again children, before whom stretches the possi- 
bility of a happy life, but who must be initiated into this 
new life. They have need of treatment other than physi- 
cians can give, of other aid than consolation and kind- 
ness. They need to be prepared for their new life — to 
be armed for the struggle upon which they are entering. 
It is true that they enter the struggle less enfeebled than 
one would think, far less than they themselves believe, 
but their capacities are of a different kind from what 
they were before, and the period of adaptation is hard." 
During this period, those privileged to care for the blinded 
soldier will need all the tact and skill at their command. 

Fortunately, the number of soldiers suffering from loss 
of sight, total or approximately so, is comparatively 



OUT OF THE DARKNESS 121 

small. i\ccording to British statistics injuries to sight 
account for but t\vo and eight-tenths per cent, of the 
disability pensions granted. In the Canadian forces up 
to date there have been blinded less than one hundred 
men. 

In starting in with the blinded soldier there are two 
primary requirements. The first is to overcome the 
deep discouragement in which the man is likely to be 
plunged. The second is to teach the soldier to be blind 
— how to accomplish the little everyday tasks which 
make life possible and comfortable. The first of these 
goes with the latter, for as the man learns how to take 
care of himself and get about with some facility, hope 
begins to return. In these early stages another blind 
man is the best teacher, and will succeed where the 
sighted fail. Sometimes a fellow warrior who has him- 
self been blinded, but has already had his start, will be 
most effective of all. The first blinded American sailor 
who returned to our training center at Baltimore was 
so far depressed that his case seemed hopeless. Nothing 
could be done with him until there was put on the job 
the first blinded American soldier, w^ho had an earlier 
start and had already "seen the light." His companion- 
ship and encouragement turned the trick, and of course 
the advantage was reciprocal. 

All along the course of re-education the blind can be 
of the greatest assistance to the sightless soldiers. They 
make good teachers for, when they argue that a thing 
can be done, it is likely to carry conviction. They know 
whereof they speak. 

Another necessity is teaching the families to have a 
blind member, and be helpful to him rather than the 
reverse. The American program for re-educating blinded 



122 THE DISABLED SOLDIER 

soldiers provides for bringing the families of the men to 
the training school for a visit, so that they may become 
acquainted with and understand the methods by which 
the men are led to be independent. If when the man 
returns home the family immediately discourages his 
ever moving out of his chair, insists that he will 
stumble if he walks about the house, and brings 
everything to him, they will be destroying the good 
accomplished during his training. It has been well 
said that ''they should not place him in a corner out of 
reach of all danger like a feeble old man or a child in 
swaddling clothes.'' They must rather tactfully encour- 
age him to do more and more for himself and urge him 
to get up and about. They must be prepared, in a word, 
to continue his re-education. 

Blinded soldiers must be protected during their period 
of training against the visits of curious but well-meaning 
people, whose ill-advised remarks will do more harm in 
a few minutes than the benefit which a teacher will 
impart in as many days. Several French schools have 
prominently displayed this notice: "To pity is not to 
console! Only words of hope and confidence should be 
spoken here.'* 

Recreation is an important factor in the social treat- 
ment of the blinded soldier. One of the primary methods 
of entertainment — with instruction combined — is reading 
aloud to a group of men. At one of the oldest schools 
for the blind in Paris a daily newspaper is read from each 
morning, the choice of the journal being determined by 
vote of the auditors. Music is another means, and the 
blind should be encouraged to take part in group singing. 
Many athletic games of considerable vigor are entirely 



OUT OF THE DARKNESS 123 

within the reach of the blind, and almost any form of 
g\^mnastic work is practical. 

For inside recreation there are playing cards with 
raised symbols of identification, dominoes with the dots 
raised instead of sunk, and sets of checkers with the 
black pieces square and the red pieces round. 

The first educational necessity for the blinded soldier 
is the learning of Braille. Fortunately, in this country 
and Great Britain the divergences of opinion which were 
responsible for the existence of several different alphabets 
have been reconciled and there has now been adopted a 
standard type. Learning this the blind man will be 
enabled to continue his reading or study to keep posted 
on current developments through a monthly magazine 
in raised letters, and correspond with his friends. He 
may write himself either in embossed print or with the 
aid of a guide to keep the lines straight and regular, with 
pencil or pen. He should be encouraged to do the latter so 
that he may not forget how. With men who were illit- 
erate before they became blind the matter of teaching 
them to read and write Braille is not so important. 

In the past the blind, like the crippled, have suffered 
from the conception that the only occupations within 
their capabilities were those of basket-making, chair- 
caning, and other similar handicrafts. Almost no schools 
had attempted teaching the more highly skilled special- 
ties. Yet the few experiments which have been attempted, 
and the instances where ambitious blind men have made 
places for themselves, show that well-paid occupations 
are not closed to the sightless. A few examples w411 show 
the manner in which the problem is approached. 

In a large factory making an ignition and lighting 
system for automobiles, much expert assembly work is 



124 THE DISABLED SOLDIER 

performed by a man totally blind. Is this man, who 
does all his work by sense of touch, under any handicap 
in competition with his sighted colleagues? As a matter 
of fact, he is probably a more faithful workman because 
he appreciates the opportunity of his job, and is likely 
to turn out a better day's product than the man next 
to him because he will not be distracted by looking out 
of the window at things going on in the street. 

In a clock factory which uses as gongs spiral coils of 
tempered wire it is necessary accurately to test and 
adjust the tone of each gong. This is done by striking 
the coil, listening to the result, and then making the 
necessary change by a screw sleeve at one end. In this 
job which requires the use of two senses only — touch and 
hearing — is a blind man at any disadvantage after he 
has acquired skill for this work? 

The first attempt in planning occupations for the blind 
is to send them back to their former trade, if this is in 
any way possible. And it will be found practicable in more 
instances than would be imagined. In actual experience 
competent blind workmen will be encountered in almost 
every line of employment. 

Two satisfactory occupations which are almost tradi- 
tional to the blind are massage and piano tuning. Men 
who have been trained in the first subject have gone 
back to employment in military orthopedic hospitals, 
where their patients are fellow-soldiers injured in other 
ways than themselves. The period of training is fairly 
long and the work only suited to men with certain quali- 
fications, but for those who can learn to be good masseurs, 
employment is secure and earnings good. In Japan the 
practice of massage has been reserved as a monopoly for 
the blind. Piano tuning is for many blind men an ex- 



OUT OF THE DARKNESS 125 

cellent business, but it is a crowded field and care must 
be taken not to train for it too many novices. 

Men employed in clerical lines before the onset of 
blindness can be trained, with the aid of a few simple 
devices, to continue their ofifice job. 

Many blind soldiers who come from the farms can 
most advantageously return to the same work. The man 
without sight is better off in many ways in the country, 
where he can get around with little difficulty, without 
the need of a guide, and running small risk of accident. 
In addition the national interest is served by his con- 
tinued activity as a good producer. 

It may appear at first blush that a blind man could 
not get on at all in work about a farm. But note the 
evidence in a letter from a blinded French soldier: 

A man used to working on the farm even if he is totally blind 
can do practically everything around the barns and stables, if 
he is not lazy or stupid. He can clean up the yards, go for water, 
rub down the horses and cows, and feed all the animals. It is 
not hard to recognize with your hands the linseed mash, the 
barley, and the bran or the oats, and to know also through your 
hands when the racks and mangers are full, and, when you 
come back later, to tell still by your hands whether the animals 
have eaten. You do not need to see to tend the winnowing- 
machine, to help in putting the grain into sacks, and then to 
put the sacks in the wagon. You can cut up beets for the cows, 
too, and you can help in making bread for the family, for in 
our part ot the country bread is made in the house. 

The work in the field is harder, I admit, but there are lots of 
tasks which you think at first are quite impossible — you would 
have laughed in the old days if anyone had told you a man could 
do them without seeing — but which now after three or four 
attempts, after three or four failures perhaps, you finally accom- 
plish. You can easily dig beets and potatoes, unload wagons. 



126 THE DISABLED SOLDIER 

and in the season thresh and spread the hay. I can't mention 
everything, of course, but there you have already quite a list. 
In addition, when it rains and you have time on your hands, 
you can make brushes, as you learned to do in the hospital. 
I should never have believed that I could be as contented as 
I am now. 

The best known institution in the world for blinded 
soldiers is ''St. Dunstan's,'* in Regent's Park, London. 
In a fine old house set in the midst of fifteen acres of 
beautiful land, are housed the British soldiers who have 
lost their sight in battle. Its ''heart and soul** is Sir 
Arthur Pearson, who lost his sight several years ago and 
who has devoted his life to the task of "teaching men to 
be blind,** as he expresses it. 

Shortly after the war began. Sir Arthur, then President 
of the National Institute for the Blind, organized the 
Blind Soldiers* and Sailors* Care Committee, which set 
about to find a suitable building where blinded soldiers 
might be trained. The selection was St. Dunstan*s, gen- 
erously placed at the disposal of the committee by Mr, 
Otto H. Kahn who had the lease of it at that time. The 
building was once the country house of the wicked Lord 
Steyne of Thackeray*s "Vanity Fair." 

On March 26, 1915, fourteen blinded soldiers entered 
St. Dunstan*s Hostel to start on the journey to self- 
support and hope. Three years later St. Dunstan*s and 
its annexes held 578 men, after having graduated 434, 
of which number ninety per cent, had been fully trained 
and set up in the occupations which they had learned in 
the school. 

The notable feature of St. Dunstan*s is its cheerful 
atmosphere. After the men have surmounted the first 
few days of depression brought on by the thought of 



OUT OF THE DARKNESS 127 

'living always in the night/' they look out for them- 
selves and go about like normal men. 

The blinded guests have very little difficulty in getting 
about at St. Dunstan's. They manage to find their way 
without the aid of a stick and w^ithout being led by the 
hand. This they are enabled to do by a unique device. 
Strips of carpet of even breadth run through the center 
of every room. As long as they can feel the carpet under 
their feet, they know there is no danger of their running 
into any obstacle. A visitor at St. Dunstan's relates that 
two men bumped into each other as they were w^alking 
in opposite directions on the same strip, but exchanged 
greetings merrily and continued on their way as if 
nothing had happened. 

To guide the men when they go about out of doors, 
other devices have been arranged. On the top and 
bottom steps of stairways, wood or lead strips are fas- 
tened to tell the men where they are. Along the paths 
leading to the various outlying buildings, railings are 
placed, with little knobs to tell the men when they come 
to a turn in the road. 

There are amusements such as rowing, swimming, 
dancing, indoor games — such as dominoes, checkers, 
chess, and cards; they have a debating society, and 
almost every man learns to play some kind of musical 
instrument. They have their theatrical clubs and last 
December gave an excellent performance of ''Babes in 
the Wood." 

But it is not all play at St. Dunstan's. The actual re- 
education and training are carried on in either classroom 
or workshop. Those who are assigned to the workshop 
in the morning are in the classroom in the afternoon and 
vice-versa. The working day is from 9:30 to 12 in the 



128 THE DISABLED SOLDIER 

morning, from 2:30 to 4:30 in the afternoon, with an 
optional extra hour for those who wish it. 

The classroom work consists largely in the teaching 
of Braille and typewriting. The men are taught to read 
and write Braille, both arts very difficult to acquire and 
involving considerable strain on the mental faculties. 
To relieve this, the Braille lessons are interspersed with 
netting, which is something of a hobby, at which a man 
can make in his spare time five or six shillings a week. 

All the men are taught typewriting, which they find 
enjoyable and at which they usually become very pro- 
ficient. 

Affiliated to this classroom work are three occupations, 
the successful performance of which requires a knowledge 
of Braille and skill in the use of the typewriter. These 
are massage, shorthand, and telephone operating. 

To learn massage demands a knowledge of Braille, 
because many of the requisite books on anatomy and 
physiology have been put into raised type. Blinded 
men have been trained as highly skilled masseurs at 
St. Dunstan's. Shorthand for the blind is a system of 
condensed Braille, and is written by means of a special 
little machine. Telephone operating on boards operat- 
ing with drop signals rather than lights is successfully 
taught. 

In the workshops at St. Dunstan's the men are taught 
cobbling, mat-making, basket-making, and joinery. 
Most of the instructors are blind and thus furnish an 
inspiring example for the pupils. 

On a spacious poultry farm, beyond the workshops, 
men are taught poultry raising on modern scientific lines. 
They learn to distinguish by touch birds of various 
breeds, to manage incubators and foster-mothers, to 



OUT OF THE DARKNESS 129 

prepare and truss birds for table, and In general to 
conduct a paying poultry business. The pupils are also 
taught rough carpentry, so that they can make hen- 
coops, setting-boxes, gates, and other farm essentials. A 
post-graduate course in poultry farming, so to speak, is 
given at St. Dunstan's Poultry Farm, near King's 
Langley, and is a month in duration. 

Wherever possible a man is returned to his former 
trade or occupation. It has been possible for men to 
resume their employment by giving them special courses 
of instruction or by teaching them special methods. 
When a man completes his training at St. Dunstan's, he 
is settled in the trade that he has studied, is equipped 
with an outfit and with an abundant supply of raw 
material. Through a carefully organized after-care sys- 
tem, he is visited regularly, his work is supervised, raw 
material is supplied to him at cost, and he is assisted in 
marketing his goods. 

Graduates of St. Dunstan's earn a fair living wage. 
It must be remembered that the blind soldier with an 
earning capacity is enabled to augment his pension which 
is not afifected by increase of income as his skill and 
earning power increases. 

In France at the beginning of 1915, when it became 
clear that the number of blinded soldiers was going to 
be considerable, the Ministry of the Interior created a 
special institution for them in an old building in the 
Rue de Reuilly, Paris. All the war blind were to be sent 
there when their medical treatment was completed. 
Accommodations were provided for two hundred persons. 
The first group, admitted in March, 1915, consisted of 
forty men. But soon the home was filled to capacity, 
and seventeen branches have had since to be created: 



130 THE DISABLED SOLDIER 

three in Paris, two in Lyons, and one in each of the 
following cities: Amiens, Bayonne, Bordeaux, Caen, 
Chartres, Dijon, Marseilles, Montpellier, Nantes, Saint- 
Brieuc, Tours, Toulouse. 

The institution is under the control of the Ministry of 
the Interior. Since its creation, however, it appeared to 
the director that, in addition, private initiative might 
be advantageously organized. He created the Society 
of Friends of Blinded Soldiers, formed of representatives 
of the Ministries of the Interior and of War, of Parlia- 
ment, of the Quinze-Vingts hospital for blind, of the 
teaching profession, of commercial circles, and of the 
Catholic, Protestant, and Jewish interests. It was 
through the efforts of this society that the different ac- 
tivities of the institution have developed. 

The Reuilly home was created as a * 'Convalescent 
Home for Blinded Soldiers,'* without any precise idea 
as to what it was to do for its inmates. It was but 
gradually and empirically that the re-education work has 
been built up. One month after the inauguration of the 
home, a very small shop for brush-making was opened. 
The experiment was successful, and the brush-making 
shop was soon overcrowded. It is still the most popular 
with the men. Since 1915, however, the re-education 
work has greatly expanded by the addition of new trades. 

At the present time, there are taught at Reuilly all 
the standard trades for the blind — brush-making, basket- 
making, making and repairing of chairs, and so on. The 
course of massage, which has been a marked success, 
consists of two sections: massage proper and theoretical 
instruction in anatomy and physiology. The latter in- 
cludes a complete course of lectures which it is neces- 
sary to write in Braille ; ability to read by touch is pre- 



















g 8 
o ^ 

fV s 



OUT OF THE DARKNESS 131 

requisite. At the end of the course, the students have 
to pass a very strict examination before a jury of physi- 
cians; they are never discharged before receiving their 
diploma. Since Februarys 1917, a group of graduates 
from Reuilly have been employed as masseurs in the 
military hospitals of Paris, and have given great satis- 
faction to the medical authorities. Others have found 
employment at the different resorts, at Monte Carlo, 
Vichy, Evian, Deauville. 

A shoe-repairing shop was established in February, 
1916. The work was first confined to pegged shoes, but 
later an invention of one of the students made possible 
hand-sewn work also. Several men have graduated and 
found employment. The first pupil of the shoemaking 
school is now employed as an instructor in a workshop 
for blind civilians. 

A machine shop, under the direction of a blind in- 
structor, has been in operation for two years. The first 
tw^elve pupils are now working in a special shop created 
for war blind. This shop is now filling orders for several 
of the largest automobile and machine plants. 

A course in piano tuning has been started on the ini- 
tiative of a prominent piano manufacturer, himself blind. 
Other courses are in crystal grinding and telephone oper- 
ating. Organ playing and singing are taught, not as 
independent vocations, but as possible supplementary 
occupations in rural localities. Macrame, raffia, and 
netting are not considered as real trades, but are taught 
to new arrivals for distraction and as a first preparatory 
exercise. 

As a general rule, all the men learn to read Braille. 
There has been established at the home a printing shop 
in which books in Braille are produced. To interest the 



132 THE DISABLED SOLDIER 

men in reading, there is distributed every morning the 
official war bulletin printed in Braille. Still more effec- 
tive in stimulating interest, has proved the pubHcation 
of the ''Reuilly-Midi," a small daily, which contains all 
the news of the institution. 

Many of the men learn typewriting, although it Is not 
intended to train them for positions of typists. For the 
use of those who wish to correspond in ordinary hand- 
writing, the administration of the home has devised a 
very simple * 'hand-guide," which permits the blind to 
write on equidistant straight lines. 

A very surprising experiment, which has given excellent 
results, is a course in fencing, directed by an expert 
teacher. 

In Germany, where a number of institutions for the 
training of blind had existed before the war, the general 
policy was that of creating in these institutions special 
sections for blinded soldiers. One of the most important 
institutions of this type is that at Breslau, which accom- 
modates about fifty men. The men are transferred to the 
school after their medical treatment has been completed 
and stay there for about three months. They are kept 
under military discipline, and the training is compulsory. 
Many of the men remain in the institution voluntarily 
after being discharged from the army; in that case they 
contribute, out of their pension, for their maintenance 
one mark a day. 

One year is considered as the average length of time 
required to teach a blind man Braille and one of the 
standard trades for blind, such as basket-making, brush- 
making, rope-making, and the like. Of these occupa- 
tions, basket-making of the rough type is the most 
popular with the men, especially those of country origin. 



OUT OF THE DARKNESS 133 

Effort IS often made to return the man to his former 
trade. The experience has been successful with several 
men, former bakers, cigar-makers, watch-makers. In 
addition to the trades taught at the institution, a number 
of men have been placed for training in industries, such 
as munition plants, clothing factories, and so forth. 

In connection with the institution, has been estab- 
lished an agricultural training station, intended mainly 
for peasants. It seems, however, that the blind soldiers 
of the agricultural class consider any special training as 
superfluous and are anxious to return to work on their 
own farms as soon as possible. 

The greatest difficulty arises with regard to men be- 
longing to the intellectual classes. Most of them, how- 
ever, are officers, and the relatively larger amount of 
their pension permits them to supplement the instruction 
given at the institution with private lessons. Many 
have been able to return to their former professions, as 
lawyers, teachers, and the like, or to resume their aca- 
demic studies interrupted when they went forth to give 
battle to the civilized world. 



134 THE DISABLED SOLDIER 

CHAPTER X 

IN WAKE OF BATTLE'S DIN 

For a number of men who return from the battlefield 
the world of sound will be forever closed. From de- 
tonation of shells, ear wounds, internal hemorrhages, and 
many other causes men are deafened at the front. They 
must face life again on a different basis. \ . 

Deafness is really more an embarrassment than a 
physical handicap. Many occupations are open to the 
deaf, so that their earning power need not be materially 
affected, but in their social and business relationships 
they are apt to suffer material inconvenience unless the 
proper steps are taken to help them surmount their 
handicap. 

The chief aim in treating the returned soldier who has 
been deafened in battle is to restore his capacity for 
mingling and communicating with his friends and busi- 
ness associates with the least possible embarrassment to 
himself or to them. It has been the experience of all 
who have studied the problem that the best way to help 
the deafened soldier is by teaching him lip-reading. Once 
he acquires skill in reading the lips, he becomes again a 
social being, cheerful and confident, and is qualified for 
a great number of occupations. 

Another urgent necessity is to prevent sensitiveness 
regarding the handicap. Otherwise a painful situation — 
both for the deafened soldier and his associates — is sure 
to ensue. When a man overcomes this difficulty, he has 
taken a distinct step forward towards success. 



WAKE OF battle's DIN 135 

It has been estimated that of all returned wounded 
soldiers one in fifty suffers from deafness in a more or 
less severe form. Returns from twelve military hospitals 
in England with a total of 67,799 patients in all show 
that 919 suffered from some form of deafness. Despite 
the fact that the number of soldiers who return with 
hearing impaired is comparatively small, the belligerent 
countries have made thoughtful provision for their suc- 
cessful reinstatement in civilian life. 

First steps to care for the British **Tommy'' whose 
hearing was impaired were taken in Edinburgh, under 
private auspices, May, 1917. Later the state took a 
hand when the Ministry of Pensions appointed a special 
Aural Board consisting of four aural surgeons and a 
lip-reading specialist. The work was then extended 
throughout the United Kingdom. 

When the secretary of this board is notified of the 
return of a deafened soldier, he communicates with the 
local pensions representative in the area in which the 
man lives. The man is then called before the official 
aurists and lip-reading specialists for examination as to 
his eligibility for training in lip-reading, for treatment, 
or both. 

At the headquarters of the board in London is one of 
the centers of instruction for the deaf. Classes are held 
morning and afternoon for regular pupils and in the 
evening for those who are employed during the day. 

Since the learning of lip-reading is quite fatiguing, it 
is necessary to provide some form of diversion for the 
pupils. In the club at headquarters the men are enter- 
tained with motion pictures, in which they seem to take 
great interest, deriving considerable pleasure from the fact 
that they can read the lips of the actors on the screen. 



136 THE DISABLED SOLDIER 

One of the oldest institutions for the deaf in France 
is the Institution Nationale des Sourds-Muets in the 
rue Saint-Jacques, Paris. Here the teaching of the deaf 
has been going on for over a century, so that the insti- 
tution was ready to handle the returned poilu when the 
call came. In some of the classes as many as eighteen 
soldier pupils have been instructed at the same time. 
Men are not yet discharged from the army, and reside 
in a neighboring military hospital. Printing, tailoring, 
and agriculture are the most successful subjects of in- 
struction at this school. 

At Bordeaux the teaching of the deaf takes place at a 
convalescent hospital on the outskirts of the town. In 
some classes there were six to eight deafened pupils, in 
others about double that number. The former sized 
class has seemed best for beginners, but with more ad- 
vanced pupils, it was desirable to have a larger number 
so that those sitting on the sides could read lips viewed 
more or less in profile. Classes could, however, be held 
simultaneously in the same room, as the deaf pupils 
were not disturbed by each other's noises. 

It appears that the German War Office established 
first a center of instruction to which were sent for 
training all deafened soldiers, but this system was criti- 
cized on the ground that it is not advisable for all the 
deaf to be collected at one place. By reason of the 
differences in dialect, it has been found better to send the 
deaf to a near-by university town, where there are ex- 
perienced teachers of the deaf. The Germans believe 
that instruction should begin as soon as the patient is 
out of the doctor's care, and that only six or at the most 
eight pupils should be instructed at the same time. 



WAKE OF BATTLERS DIN 137 

The English regard three months as sufficient time 
in which to teach lip-reading. The French do not 
require that much time under their system, while the 
Germans ask for at least five or six months for a full 
course of instruction. 

With lip-reading thoroughly mastered, and the 
deafened soldier being reaccustomed to social and 
business relations under his new handicap, almost all 
vocations are open. Men with a skilled occupation can 
almost universally return to their former job. A few 
employments noted as unfavorable for the deafened are 
those of chauffeur, motorman, conductor, salesman, 
telephone operator, work where overhead cranes and 
other shifting machinery is used, or about railroad 
tracks where hearing is essential to safety. Regarded 
as good trades are motion picture operating, photography, 
typewriting, fiHng, clerical work without dictation, farm 
work, stock room or shipping clerk, plumbing, tailoring, 
bookkeeping, printing, baking, and civil service positions. 

Among sixty-nine deafened soldiers trained at Lyons, 
France, thirty-nine were prepared for agriculture, eleven 
for manufacturing, nine for commerce, and ten for mis- 
cellaneous jobs. 

The Division of Physical Reconstruction of the United 
States Army, under the Surgeon General, has established 
through its Section of Defects of Hearing and Speech 
a center for treatment in connection with United States 
Army General Hospital No. 11, at Cape May, N. J. 

After a thorough consideration of all the methods 
employed by the other countries, both allied and enemy, 
it was considered that the best manner in which to 
handle reconstruction patients along this line, was to 
establish a central point at which they could be treated 



138 THE DISABLED SOLDIER 

under full military discipline. It was decided that it 
was impossible to define, when a patient was first ad- 
mitted into the hospital, whether he was a patient 
appropriate for discharge along one of the three lines into 
which reconstruction patients are to be classified, until 
he was thoroughly subjected to the line of treatment 
that was thought adequate for his condition. Not only 
this, but it would seem from the work in connection with 
the British and other allied nations' reconstruction en- 
deavors, that the most advantageous course to be pur- 
sued in connection with these men was to hold them in 
the army until physically qualified thoroughly to take 
care of themselves in their contact with the outside 
world. 

Actuated by these two motives, the chief of the section 
decided to concentrate all ambulatory cases at United 
States Army General Hospital No. 11. Cases with 
multiple injuries and other diseases which necessitate 
their being retained in other United States Army general 
hospitals will receive their treatment in these hospitals, 
from reconstruction aides who will be transferred, dur- 
ing such course of treatment to the hospital at which 
the patient is confined. By this means the patients 
receive both their general medical and surgical treatment 
as well as their aural treatment. This at the same time 
minimizes the period of time which the patients will 
have to spend in the hospital. 

The wisdom of this procedure has already been demon- 
strated during the three months in which the activities 
of the section have been progressing in connection with 
this work. 

It must be understood that patients are receiving 
treatment along all lines which aid in their restoration. 



WAKE OF battle's DIN 139 

These men are thoroughly and carefully classified. Many 
of them require thorough surgical and medical treatment 
besides those measures which are essential to their audi- 
tory re-education. The auditory re-education is not 
entirely along one line of treatment. Besides the various 
types of medical attention given these individuals, aur- 
icular and speech reading methods are also employed. 

One of the first men to be deafened in France was 
illiterate and so must needs be trained to read and write 
as well as to interpret the movement of the lips in terms 
of sound. The patients at United States Army General 
Hospital No. 11 have shown that true American spirit 
of enthusiasm and effort. Results indicate that the 
average period of treatment and training equals the 
French, and probably exceeds it. 

An unofficial serv^ice to cooperate with the government 
authorities has been organized by the Industrial Union 
for the Deaf and the Volta Bureau. The objects of this 
service are to aid men to retain their former powers of 
speech which are likely to suffer from disuse, to teach 
them to read the lips as rapidly as possible, to educate 
employers to a realization of the value of lip-reading and 
thus pave the way for the employment of the deaf, 
where some hearing is left to develop and re-educate 
that hearing in the hopes of possible recovery, and to 
offer vocational advice to those who must enter new 
and unaccustomed fields of labor. Facilities for the edu- 
cation of the deaf are excellent in the United States, and 
all will be at the service of the deafened soldier, should 
their utilization seem wise. 

A rather exceptional opening for the deaf is in plants 
where the noise is such as to impair the hearing of normal 
workers. One concern which used to deafen totally or 



140 THE DISABLED SOLDIER 

partially each year scores of employees has now stopped 
the damage by seeking out for the jobs men already deaf, 
who will suffer, therefore, no further injury. Compensa- 
tion expense has been cut to a minimum, and deaf can- 
didates for employment are at a premium. 

An encouraging augury of the attitude of American 
employers toward the discharged deafened soldier is the 
present intelligent utilization of deaf workmen in some 
of the largest plants. One tire concern, for example, 
has four hundred employees who cannot hear, and an 
automobile concern lists three hundred more on its 
payroll. 

With modern provision the transition of the deafened 
man from the din of the battlefield to profitable employ- 
ment in industry can be accomplished with difificulty 
slight indeed. 



THE STEP IN TIME 141 



CHAPTER XI 

THE STEP IN TIME 

The greatest number of discharges from the army for 
physical disabiUty for any specific cause is chargeable to 
pulmonary tuberculosis. The largest number of pensions 
awarded in Great Britain up to January, 1918, went to 
men with lung diseases, which accounted for twelve 
per cent, of the total disability grants made, and by the 
end of 1917, a total of 20,000 British soldiers had been 
invalided home for pthisis. The early discharges from 
our own army in camp and field were of men who had 
developed a tuberculous condition. 

Many of the cases were due to imperfect medical 
examination at the time of admission to the army, a 
considerable number of active cases of tuberculosis being 
passed in the first rush of recruiting and conscription. 
Some oversights were due to carelessness of medical 
examiners, others to the fact that it is difficult for a 
physician without special experience in dealing with the 
tuberculous to detect cases in the incipient stages. 

There was ample warning in the experience of other 
countries as to the importance of the examination for 
tuberculosis. Canadian representatives warned that it 
should have special attention, adding the caution that 
every case missed would cost the government over five 
thousand dollars. And care was taken, but in spite of 
it, a certain number of men slipped through. 

The interesting thing about discharges for tuberculosis 
is that the disease is almost never contracted in the 



142 THE DISABLED SOLDIER 

army but is brought in during its active condition or, 
more frequently, while latent or quiescent. In the latter 
instance the rigors and exertion of camp life have lighted 
the sleeping fires and made the case active. While the 
original infection, therefore, accurately speaking, was 
not incurred in military service, the state of active 
tuberculosis was due to army work and would probably 
not otherwise have existed. 

The tuberculous soldier almost universally desires im- 
mediate discharge from the army, award of his compen- 
sation for disability, and permission to return to his 
home. This would mean, in almost every instance, 
that his condition would grow progressively worse rather 
than better. The ideal arrangement would be for him 
to remain in the army for treatment until he is cured, or 
at least until his case is substantially arrested. During 
the period of care his family will be provided for by the 
allotment of military pay, and the additional allowances 
made by the government. The opportunity of free 
treatment and support of himself and his family until 
he is cured is one that will never come to him again. 
Propaganda to educate the public to wisdom regarding 
the disabled can greatly further the probability of the 
tuberculous consenting to treatment. 

Even though the man knows that it is the best thing 
for his health, it is hard for him to make up his mind to 
leave his family for a year or possibly for longer, to go 
alone to a sanatorium. He may conceivably prefer to 
take his chances on the question of health and life. The 
matter is made much the more difficult by the location 
of some of the military hospitals at, seemingly, the ends 
of the earth, where it is out of the question that he 
could ever be visited by his family. Were units for the 



THE STEP IN TIME 143 

tuberculous made more accessible, it is likely that the 
plans for treatment would be more readily acceded to, 
and the families of the men, seeing with their own eyes 
from time to time the progress made, would more easily 
be reconciled to continuance of the treatment. 

Even if a man is reluctant to enter upon a long term 
of treatment, a short period under regular medical super- 
vision will do him a great deal of good, in that he will 
learn how to protect others from infection at his hands, 
and will become acquainted with the principles of fresh 
air, food, sleep, and the like which he caii follow out 
after his return home in the form of self -treatment. In 
other words, he will learn the factors upon which re- 
covery from tuberculosis depends, and will have become 
accustomed in some degree to the daily regime. It is 
largely for this reason that the Surgeon General of the 
Army has ruled that all tuberculous soldiers must be 
retained under treatment for at least three months. 

Ever since it has been demonstrated that occupational 
therapy is of great value in the treatment of the most 
varied disabilities, the question of its possible value in 
the treatment of tuberculosis has been the subject of no 
little debate. Many American and German specialists 
have maintained that if a permanent arrest of lung- 
disease is to be secured, a prolonged period of rest must 
be taken by the patient and that this rest must be 
I •''surgical rest*' as long as active symptoms continue 
or so long as fever persists. English specialists, however, 
appear generally to believe in prescribing a considerable 
amount of vocational work in all except the hopeless 
cases, and as soon as the patient who has a ^'chance'* 
loses the most distressing symptoms. The exercise pre- 
;3crib^d is at first walking only, but ''such monotonous 



144 THE DISABLED SOLDIER 

occupation is gradually replaced by light and useful 
work, increased little by little until at last, before their 
discharge, the most favorable cases do six hours' hard 
navvy work a day." 

There can be no doubt that some forms of occupational 
activity are of great advantage in the treatment of the 
tuberculous soldier, if only for psychological reasons. 
For there is a difference between the frame of mind in 
which a civilian afflicted with the disease enters upon 
the treatment, and the attitude of the soldier who is 
sent to a sanatorium. It has been reported, for instance, 
that in the Canadian military hospital at Ste. Agathe 
des Monts, Quebec, ''on account of the excitement, 
danger, and adventure of their life at the front'* the 
invalided soldiers ''were not only indifferent to the ordi- 
nary methods of treatment" — prolonged rest, followed, 
after many months, it may be, by gradually increased 
"doses" of mild exercise — "but openly rebellious against 
such methods." Within six months of the opening of 
this sanatorium, one-third of the soldiers had refused to 
continue the treatment, and fifteen per cent, had to be 
dismissed for "open insubordination usually terminating 
in drunkenness." After this experience, treatment along 
vocational lines, less strenuous than that advocated by 
the English experts, w^as resorted to, and with very 
satisfactory results. Enthusiasm for the treatment has 
replaced the former indifference, insubordination has 
been reduced to less than two per cent., and instead of 
refusal of treatment, there have been applications for 
extension of time to permit vocational courses to be 
completed. 

This experience makes it clear that the tuberculous 
soldier presents a special problem, in that methods to 



THE STEP IN TIME 145 

which a civilian submits voluntarily and without a 
murmur become dangerous because of their psychological 
effect on the average soldier, the prolonged rest seeming 
nothing more than enforced idleness, leading therefore 
to irritation, depression, discontent, boredom, and fre- 
quently to sudden rash acts. Obviously, all these unde- 
sirable results can do more to delay improvement than 
a system of well-regulated occupational therapy pos- 
sibly can. 

The soldiers' sanatorium at Ste. Agathe, Canada, is 
typical of many establishments that have been founded 
the world over to care for the unprecedented numbers of 
disabled soldiers. Ste. Agathe is a sleepy, picturesque 
French- Canadian hamlet four hours' train journey into 
the hills and forests northwest of Montreal; before the 
war it had its summer colony, its winter sports, its inn, 
and a sanatorium for tuberculous civilians. In the 
winter of 1916, the inn was taken over for the treatment 
of tuberculous soldiers by the Canadian government, and 
converted into a sanatorium with a capacity of seventy- 
six beds. Since that time, the other sanatorium, which 
still has its quota of civilian patients to care for, has 
placed fifty beds at the disposal of the military. After 
the experience to which reference has been made, the 
military hospital was provided with specially designed 
workshop and school buildings. 

In accordance with common sanatorium practice, the 
soldier-patients at Ste. Agathe are divided into three 
classes. The first class consists of infirmary cases, in 
whom the disease is in its acute stage ; they are confined 
to bed until the distressing symptoms disappear. Under 
careful supervision, these patients are permitted to 
beguile the tedium of the sick room with knitting, draw- 



146 THE DISABLED SOLDIER 

ing, crocheting, cardboard work, raffia weaving, and 
study. 

The second class consists of porch cases — those which 
have progressed so far as to go to the dining room for 
meals and look after themselves, spending the day on 
reclining chairs in the open air. In addition to the occu- 
pations permitted the infirmary cases, porch patients 
may take up reed basketry, stenography, and penman- 
ship as their strength increases — but always under careful 
surveillance. On the first indication of trouble, they are 
immediately returned to the former classification until 
all danger is passed. 

Class three is subdivided into six groups, according as 
the time prescribed for exercise and vocational therapy 
varies from fifteen minutes to two hours daily. As soon 
as a patient has progressed to the point where he can be 
permitted half an hour^s exercise a day, he is given the 
opportunity of spending half this time in the workshop. 
Class three patients are offered the choice of instruction 
in basketry, carving, clay modelling, metal work, picture 
framing, illuminating, engraving, or, in the school build- 
ing, of instruction in French, English, and in subjects 
preparatory for civil service positions. In the summer, 
the more favorable cases take up a little gardening. As 
in the second class, these patients are constantly watched 
for dangerous symptoms; as soon as any appear, the 
patient is returned to a less advanced category. 

The workshop and the school are very simple structures 
designed to afford the maximum of fresh air and comfort. 
The classes are well-attended, and relapses are rare. 
Twenty-nine out of thirty-two patients who prepared for 
civil service positions have since passed their examina- 
tions with good averages. 



THE STEP IN TIME 147 

The great defect of sanatorium treatment has hitherto 
been the fact that a large number of cases discharged 
with the disease apparently arrested sooner or later 
suffer a relapse. This has been true particularly of those 
patients who must support themselves, usually at some 
manual trade. The chief reason for this condition is 
doubtless the fact that the sudden change from perfectly 
hygienic surroundings with plenty of good food and fresh 
air and medical attention to the conditions under which 
the less well-off must so frequently live and work is a 
strain which many patients cannot withstand. It is 
therefore important that the period after discharge be 
wisely considered and planned for. 

With this fact in mind, the army medical authorities 
in the various belligerent countries both at home and 
abroad have taken a number of preventive and precau- 
tionary measures with regard to this critical period. One 
of the obvious steps was the consideration of vocational 
possibilities. All occupations involving severe physical 
exertion or prolonged stay in a dust-laden atmosphere 
are impossible. The best seem to be outdoor and semi- 
outdoor occupations ranging from farmer to chauffeur, 
from policeman to ticket-collector and traveling sales- 
man, and the like. Most patients seem to prefer, how- 
ever, to return to their original vocations; and whenever 
the working conditions permit it the authorities make 
no objection. Even the best occupations have features 
that are not ideal for the worker with a tubercular his- 
tory. Indeed, the factors that enter into the problem 
are so many and varied that almost every case must be 
judged on its own merits. Nevertheless, it is most im- 
portant that it be so judged, and that steps be taken in 
each case to eliminate as many objectionable features 



148 THE DISABLED SOLDIER 

obtaining under the former working and living conditions 
as possible. In Germany the organized cooperation of 
the employer in this direction is asked for. 

Recognizing the vital importance of the post-sana- 
torium period, the Surgeon General of the United States 
Army has approved a plan for *'after-care*' which involves 
the cooperation of various civilian agencies. Cooperation 
is secured through the National Tuberculosis Associa- 
tion. This body forwards the names of all soldiers in- 
valided because of lung-disease, and of all civilians 
rejected for army service for the same reason, to such 
local organizations as public health boards, state anti- 
tuberculosis societies, and the local agencies of civilian 
relief of the Red Cross. These agencies share the work 
of supplying the War Risk Insurance Bureau with the 
required data concerning the economic and social cir- 
cumstances of the disabled soldier and his family, of 
providing such medical examination, attendance, and 
other care as may be needed, the Red Cross assuming 
the burden of supplying the family with any necessary 
financial relief during the period before this duty is taken 
over by the proper community relief organization. 

Another step in the direction of "after-care** that seems 
to have been taken simultaneously in the United States, 
in England, in Germany, and perhaps elsewhere, is the 
development of an institution that is to serve as an inter- 
mediate step between release from the sanatorium and 
return to complete economic usefulness. In England 
these institutions are called "farm colonies,** in Germany, 
"convalescent work-homes**; in the United States they 
have as yet received no generic designation. But the 
purpose of them all is very much the same — to take up 
the treatment where the sanatorium must properly drop it. 



THE STEP IN TIME 149 

The sanatorium strives to retain its patients until the 
disease is diagnosed as ''quiescent** or "arrested." The 
patient so released is rarely in possession of his full 
strength. He has been living an artificially sheltered life, 
even though he may have been engaged in vocational 
work for a number of hours daily prior to his discharge. 
Psychologically and physiologically he is not always fit 
to resume forthwith the struggle for existence among his 
fellows. It is at this point that these new institutions 
fit in, their primary purpose being to bridge the gap, to 
provide a "hardening" period. A secondary but very 
important purpose is to continue the vocational training 
already begun in the sanatorium. 

These institutions take various forms. In New York 
City, after an investigation had revealed the fact that 
forty-five per cent, of the patients of a certain sanatorium 
had relapsed or died within six monhs to two years after 
their discharge, the Committee for the Care of the Jewish 
Tuberculous decided on a system of after-care, one of 
the features of which was the establishment of a factory 
for employment of some of the cases. Since over sixty 
per cent, of their charges were needle-workers, the factory 
was fitted up to enter this field of work. An ordinary 
well-lighted loft was rented, additional windows sup- 
plied, machinery installed. The windows are always 
kept open, a comfortable temperature is maintained, the 
strictest hygienic conditions prevail. Only "negative 
sputum" cases are accepted. For a number of months 
after admittance, the workers are examined every week 
or two, later on every three or four weeks, and, after six 
months, every four or five weeks. Work is paid for on a 
piece w^ork basis at rates at least as good as those ob- 
tained by normal workers elsewhere. The employees 



ISO THE DISABLED SOLDIER 

work from two to eight hours daily, according to the 
doctor's ruling. 

As a result of this intermediate institution and other 
after-care — such as visiting, home-instruction in hygiene 
and treatment, the provision of financial aid when neces- 
sary, and the like — relapses have been kept down to 
fifteen per cent. In a recent report by the director of 
this institution it was emphasized that for the past 
seventeen months the factory has been entirely self- 
supporting. It is probable that similar institutions will 
play a part in the after-care of the military tuberculous. 

It will not be long, doubtless, before large industrial 
establishments will find their way toward cooperating in 
this work by assigning certain positions — whole depart- 
ments, perhaps — especially suited to the tuberculous as 
opportunity for either the permanent employment of 
such workers or for employment during the hardening or 
post-sanatorium period. One of our largest automobile 
factories has already undertaken cooperation of this sort. 

Great benefit to the community will ensue from suc- 
cessful provision of after-care for tuberculous soldiers, 
and conversely great injury will result from half-hearted 
attention to the problem. 



BRINK OF THE CHASM 151 

CHAPTER XII 

BRINK OF THE CHASM 

The force of modern high explosives and the strain of 
trench warfare have added to the old sad list of soldiers* 
disabilities a new one, known as shell shock. The term is 
familiar to everybody, but probably many people have 
no very definite idea of the condition it describes. 

You may have seen a Canadian officer home on a fur- 
lough, suffering, you are told, from shell shock, and have 
remarked his haggard eyes, his nerv^ous starts, the reso- 
lute grip on his cane by which he tried to conceal the 
trembling of his hand. Or you may have read of shell 
shock victims in the hospitals, men w^ho jerk and shake 
in every limb, whose minds have become a blank, or who 
are blind and deaf from shock. You have perhaps not 
realized, however, that shell shock is only a new expres- 
sion for an old class of diseases, diseases of the nervous 
system which attack men in peace or in war when they 
undergo great strain or shock. Shell shock is simply a 
collective term for the well known psychoneuroses, 
hysteria, neurasthenia, and the like, brought on by the 
events of the war. A more accurate term would be ' Var 
psychoneuroses'* or merely 'Var-neuroses.** The war- 
neuroses, just as the neuroses of ordinary life, are purely 
functional nervous affections and are not caused by a 
physical injury to a nerve or to the brain. A victim 
of shell shock may be unable to raise his arm or to speak, 
but his condition is utterly different from that of the 
man whose arm is paralyzed because the ulnar nerve 



152 THE DISABLED SOLDIER 

has been severed by a bullet or who has lost his speech 
from a shell splinter in his brain. In the shell shock 
patient the psychic impulse to move the arm or to speak 
cannot be translated into action ; apparently the patient 
has forgotten completely how to move the arm or how 
to speak although the physical mechanism for the move- 
ment or speech remains intact. 

The number of men disabled in the present war by 
nervous and mental diseases — shell shock, hysteria, neu- 
rasthenia, and insanity — is large, but perhaps not sur- 
prisingly so when one considers the almost superhuman 
endurance and fortitude demanded of the modern soldier. 
In British pension statistics dealing with men discharged 
from the army up to May, 1918, shell shock ranks with 
the major disabilities, accounting (with insanity and 
epilepsy) for seven per cent, of the discharges. During 
the same period rheumatism disabled only six per cent, 
and tuberculosis eleven. These figures do not, however, 
represent the full total of the nervously disabled, for 
many men discharged for other disabilities also suffer 
from nervous disorders. The number of British pen- 
sioners afflicted with nervous diseases is stated by one 
authority to be nearly twenty per cent, of the total. 

Cases of insanity among soldiers differ from those 
occurring among civilians only in the war coloring of the 
sufferers* delusions. In the allied countries they are 
treated by the army medical service until they recover 
or until they are recognized as incurable, when they are 
sent to regular hospitals for the insane. 

Classed together under the term shell shock are many 
different kinds and degrees of nervous disorder. These 
range from a temporary loss of self-control to such a 
severe shattering of the nerves that the patient is a 



BRINK OF THE CHASM 153 

mental and physical wreck. Symptoms van- greatly in 
different individuals and are both mental and physical 
in character. Some men appear tired and depressed; 
others are irritable, worried, or terrified. They are usu- 
ally afflicted by severe headaches, and at night they are 
troubled by violent nightmares. A common type of 
war-neurosis is the hypochondriac with his thoughts 
constantly centered upon his real and imaginar>^ pains. 
Inability to concentrate the attention on anything marks 
another type, and still different is the man who sinks into 
complete mental torpor, sitting for days indifferent to 
all around him, too apathetic to wipe away a tear that 
may roll out of his eye. Other mental symptoms are 
tangled thoughts and partial or total loss of memor\'. 
On the physical side, the victim of shell shock frequently 
has a disordered heart action and strange tremors in his 
limbs. His head may waggle uncontrollably and piti- 
fully, or his feet drag helplessly along the floor. Among 
the severer effects are puzzling cases of muscle contrac- 
tions and paralyses, authentic signs of physical injury 
without a scratch on the body. A large number of shell 
shock cases lose temporarily their sight, hearing, or 
speech, becoming in all reality blind, deaf, or dumb 
though there has been no injury- to their sensor}^ organs 
or nerves. 

The derangement of the nervous system indicated by 
these symptoms is inadequately described by the term 
shell shock, for the condition occurs in men who have 
never heard an exploding shell. It is not necessarily 
caused by the concussion of high explosives with the 
accompanying noise and horrid sights — the psychic 
trauma of battle — but is as often brought on by the 
physical and emotional strains the soldier has to bear. 



154 THE DISABLED SOLDIER 

Great fatigue, lack of sleep, cold, hunger, mud, and filth 
wear a man down to the breaking point. Then fear 
begins to clutch at him, and worse, the fear of being 
afraid. He struggles with his fear and conquers it, but 
each victory is at the cost of nervous energy. He sup- 
presses all expression of his emotions and cultivates a 
soldierly indifference to the loss of comrades and the 
ghastly incidents of war, but the suppressed feelings wait 
their chance to gain the upper hand. At any time now 
the collapse may occur, or it may hold off until it is pre- 
cipitated by some violent shock — the explosion of a shell 
which buries him beneath corpses and debris, or bad 
news in a letter from home. 

Even when the actual atmospheric concussion from an 
exploding shell is violent enough to knock a man uncon- 
scious, it does not appear to be the prime cause of the 
nervous collapse. Men who are severely injured by shell 
fragments are only slightly affected by shell shock, while 
men who escape serious bodily injury suffer the greatest 
nervous disturbance. As has been said, the physical 
and emotional strains of the soldier's life play an im- 
portant part in the result, but in many cases the deter- 
mining cause is an innate nervous instability, a predis- 
position to hysteria or neurasthenia. Many men are 
temperamentally unfit to be soldiers, and these are the 
likeliest victims of shell shock. They are often men who 
have displayed great bravery, men who have volunteered 
for desperate trench raids or to carry despatches through 
a barrage, but they lack the nervous energy for keeping 
up their effort. Far from being a reflection on a man's 
courage, shell shock shows that he has spent himself to 
the utmost. 



BRINK OF THE CHASM 155 

When a man is nervously spent, his will loses the mas- 
tery and long suppressed desires or fears rule. In the 
shell shock victim the dread of battle, the fear of death 
and injury, so long kept under, holds sway over both 
mind and body. The man is not a malingerer, but his 
mind exerts a subconscious influence on his bodily con- 
dition. While his body is unfit, he cannot go back to the 
front: under the influence of his ruling wish to escape 
further suffering, his body therefore refuses to mend. 
Many cases of shell shock are clear examples of such 
hysteria. One case reported by an Austrian physician 
was of a South Slav soldier whose leg after shell shock 
remained stiff for many months. In the course of the 
man's hospital sojourn he contracted tuberculosis, a 
ground for discharge from service, and the leg rapidly 
recovered. In other recorded instances, where the eye- 
sight has been temporarily lost, the sight has returned 
most slowly to the shooting eye. 

The treatment prescribed for shell shock cases in the 
early acute stage is rest in bed, good food, and cheerful 
surroundings. This treatment is provided for the 
British and French armies in special shock hospitals just 
behind the lines. Under it a large proportion of the cases 
rapidly recover and in three or four weeks are usually 
sent back to the front. Cases which show that they will 
not recover quickly are evacuated to the base hospitals, 
and then, if they are British soldiers, are sent back to 
England, the milder cases to general convalescent hospi- 
tals and the severer ones to special neurological institu- 
tions. Discharged soldiers still suffering from nervous 
diseases are able to obtain additional treatment in certain 
so-called Homes of Recovery organized for their benefit 
by the Pensions Ministry. These Homes of Recovery 



156 THE DISABLED SOLDIER 

have done Invaluable work in restoring to nerve-shattered 
ex-soldiers the ability to live and work as normal men. 
Their success seems to have been due not a little to the 
fact that the men taking treatment have no fear of being 
returned to the front when they are cured. 

Segregation in special institutions seems on the whole 
desirable for nervous patients. Against it has been 
urged the facts that a patient's depression or irritability 
may be increased by his companions' nerves and that he 
is apt to imitate others' symptoms, but these arguments 
have not been supported by experience. On the other 
hand it has been found that a nervous case in the general 
wards of a hospital attracts painful attention from the 
other patients, and that his tremors, stuttering, or 
shuffling gait are made the subject of their jokes. A man 
whose ills are what wounded men call imaginary can 
expect from them little sympathy. 

In any institution where shell shock cases are suc- 
cessfully treated, the greatest care is taken to make the 
surroundings cheerful and to have the atmosphere 
charged with optimism. Patients of this kind are ex- 
tremely sensitive to suggestion. If they are to recover, 
everything around them must suggest hope and recovery. 
The first step in the cure is to make them believe they 
are going to get well. In this task the personality of 
doctors and nurses plays a big role. They must have 
common sense, real sympathy, the strength of will to 
disguise it, and great confidence, but above all the power 
to command their patients' confidence. 

It is the doctor's first duty to find out what is worry- 
ing his patients. He may use the simple method of 
sympathetic questioning or the modern psychoanalysis, 
but his aim is always to bring to light the hidden 



BRINK OF THE CHASM 157 

complex which is at the root of their nervous symptoms. 
He then tries to make the patients understand their 
symptoms, to face squarely the facts responsible for their 
breakdown, and to build up their will power. Physical 
treatment, such as electric currents, baths, and massage, 
may be a valuable adjunct to psycho-therapeutic meas- 
ures but can easily be overdone. If it tends to center 
the patient's interest more closely on his condition, it is 
definitely bad. 

Suggestion has effected some sudden and dramatic 
cures and is always a powerful aid in furnishing the 
initial impulse to self-control. A simple illustration is 
the man who insisted that his left leg was completely 
paralyzed. Asked about the strength of his right leg, 
he kicked out with it strongly, unconscious that he was 
at the time standing on his left. Similarly, men who 
have lost their power of speech have found it when 
physically hurt or through suddenly joining in the well- 
known chorus of a song. Suggestion cures are, however, 
not always permanent, for while the fixed idea may be 
dissipated, the state of mind which made it possible 
remains. This must be changed by longer treatment. 
The affected muscle groups must also be systematically 
re-educated before the cure is complete. The case of a 
Canadian soldier suffering from paraplegia is interesting 
both for the psychic cause of his trouble and for the 
way in which he was cured. The man in question re- 
ceived a slight wound and a severe shock from the 
explosion of a shell which blew in the wall of the trench 
where he was standing. The wound healed rapidly, but 
the purely functional paraplegia persisted with great 
stubbornness. On being questioned, the man said that 
he had seen a companion have both legs blown off; later 



158 THE DISABLED SOLDIER 

he admitted that he had a sister unable to walk and 
that he had dreaded receiving an injury which would 
make another helpless invalid in the family. In the 
endeavor to prove to him that his fears were unfounded, 
the doctors anesthetized him and while he was uncon- 
scious raised his legs in front of him with bent knees. 
When he came out of the anesthetic, he was told that 
he had himself raised his knees and was ordered to lower 
them into a more convenient position. The result was 
a distinct movement of the muscles. From this time the 
man knew that his muscles were not lifeless, and through 
graduated, continued practice he finally regained com- 
plete control. 

Since the main factor in the cure of any functional 
nervous disease is the will of the patient, everything 
must be done to make life seem worth while to him. 
Games and gentle sports in the open air are beneficial, 
but better than anything else is some light interesting 
work. Almost any kind of work will serve the purpose 
if it is not too fatiguing or so monotonous that it becomes 
mechanical. Creative work with the fingers is usually 
attractive to nervous patients. If it is in addition work 
in which they can progress by definite steps, always 
conscious of their own improvement, it seldom fails to 
have an excellent effect upon both their spirits and their 
bodies. After a few weeks or even days of some con- 
genial occupation, men begin to take a new interest in 
life. Their eyes brighten; their limbs stop trembling; 
they are no longer racked by dreams. With the awaken- 
ing of their interest their will and initiative are also 
aroused, and their cure then is not far off. 

Various occupations have been introduced into the 
hospitals and convalescent homes of our allies as a means 



BRINK OF THE CHASM 159 

of refitting nervously shattered men for the business of 
life. At the Central Hospital for Nervous Diseases at 
Cobourg, Ontario, to which are sent the severer shock 
cases among the Canadian returned soldiers, patients are 
started at some simple occupational work such as bas- 
ketry or clay modeling; as they become capable of 
greater effort, they are directed to carpentry, pottery, 
or gardening. At Golders Green in London, the first 
Home of Recovery for discharged soldiers unable to 
earn a living because of their nervous condition, great 
emphasis is placed on intensive garden culture. French 
methods are used — cold frames, cloches, heavy fertilizing, 
and other means of forcing — and a surprising number of 
vegetables are produced on a small plot of ground. It 
is hoped that the work will not only serve a remedial 
purpose, but that it will provide a livelihood later to 
men who can never make a complete recovery. In con- 
nection with the garden culture, there are operated 
carpentry, ironworking, and basketry shops for making 
the glass frames, packing crates, tools, and containers. 
Other shops are for motor mechanics, electric fitting, 
and shoemaking. 

Most of the occupational work for men disabled by 
shell shock has value as a therapeutic measure rather 
than as trade training. Its object is the restoration of 
the men's health, not their re-education. When they 
are recovered, they are expected to return to their former 
occupation. If after being cured of their nervous 
troubles they are still unable to take up their old calling, 
they must go elsewhere for serious training in a new 
trade. 



160 THE DISABLED SOLDIER 

CHAPTER XIII 

ALLIES ON THE CONTINENT 

When the call to war broke in upon the serenity of 
France, most of the able-bodied population sprang to 
the colors — with the result that we now know so well. 
There was no provision then for the training of cripples, 
but as men began to return disabled, an organization for 
their re-education was hastily built up to meet the neces- 
sities of the situation. 

What respect we must have for the work done in 
France! With her national existence threatened, with 
a powerful enemy not far from the gates of Paris, that 
gallant country with which the United States is now 
proud to be allied, gave careful thought to the future 
of the men injured in her defense. And in spite of the 
difficulties, that work for disabled soldiers was so credit- 
able and so imbued with sound spirit as to serve for 
example and inspiration to the world. 

The enterprise which prompted the foundation of the 
Lyons school, as already described, was not unique. A 
similar spirit prevailed in the foundation of scores of 
similar schools throughout the republic. The men who 
founded them were all pioneers, working it is true on a 
common problem, but each almost on original lines. We 
may properly expect, therefore, that French experience 
will show much to follow and much to avoid — the one 
as helpful as the other. 

In almost every community in France, as men dis- 
charged from the army because of their disabilities 



ALLIES ON THE CONTINENT 161 

began to return to their homes, societies were formed 
for the purpose of organizing some system of aid to the 
broken and often destitute soldiers. These various soci- 
eties and committees throughout France soon recognized 
that the Lyons committee headed by Mayor Herriot had 
found the best way for really aiding disabled men — a 
far better way than giving them money allowances or 
placing them in the trifling jobs open to untrained, 
handicapped men. The committees in the larger cities, 
which were able to collect the necessary funds, took 
steps therefore to open similar schools in their communi- 
ties. In Montpellier, Bourges, Saint-Etienne, Bordeaux, 
Rouen, Toulouse, Marseilles, Pau, and many other cities 
schools were organized during the first eighteen months 
of the war. The expense of the undertaking was in most 
cases originally borne by private subscriptions, but as 
the value of the w^ork became generally recognized, the 
municipal or departmental government assigned funds 
for its support, and in course of time the school usually 
passed under the control of one of these administrations. 
The first re-educational school to be established and 
maintained by the national government was opened at 
Saint-Maurice, a suburb of Paris, in May of 1915. The 
government took over for this purpose a group of build- 
ings which had been used as a public convalescent home 
and a home for industrial cripples. It installed here not 
only a finely equipped trade school with dormitories 
and workshops but also a military hospital in which a 
certain number of beds were reserved for men who 
wished to take courses in the school. By this arrange- 
ment hospital treatment and trade training were dove- 
tailed; that is, men were enabled to start their occupa- 
tional work before the completion of their hospital 



162 THE DISABLED SOLDIER 

treatment. Most of the provincial schools had no such 
hospital connection, nor did they at first desire it, being 
of the opinion that a man should be thoroughly cured 
of his wounds before he attempted any kind of work. 
After two years of experience, however, the value of co- 
operation between hospital and school was apparent, and 
the government took measures to attach the existing 
schools to military hospitals in the vicinity and to or- 
ganize new schools wherever there were no re-educational 
facilities within the reach of convalescent patients. It 
is now an accepted principle with French authorities 
that every man, before he is discharged from hospital, 
should have the opportunity to take up some form of 
training for self-support. 

The schools have found their usefulness greatly in- 
creased by this arrangement, for it has enabled them to 
recruit more pupils and to obtain better and quicker 
results. Patients in a hospital, with the example of their 
comrades before them, can be more easily induced to 
enter upon a course of training than men who have re- 
turned to their homes and been already a little spoiled 
by the hero-worship of their friends and families. Work 
begun as early as possible in the convalescent period 
is, moreover, an excellent preventive of that malady 
sometimes known as hospitalitis, which so insidiously 
attacks the will and ambition of long-term patients. 
The saving of time to the men themselves is of course 
invaluable. 

Some of the societies organized in Paris to render aid 
to the returned soldiers have acquired a nation-wide 
membership and through powerful public appeals have 
been able to raise large sums for their purpose. Part 
of their resources have been devoted to establishing 



ALLIES ON THE CONTINENT 163 

employment agencies and to furnishing better artificial 
limbs, but more and more of their energies are being 
turned toward providing opportunities for re-education. 
This they have done in general through financial aid to 
schools started by others, though wherever they have 
perceived the need they have created new schools. They 
have also placed large numbers of men as apprentices 
with private employers. 

An interest in the future of French industr>% joined to 
an earnest desire to help the glorious mutiles, has in- 
fluenced other groups to take up the work of refitting 
injured men to be productive wage-earners. Those 
trade unions which already possessed facilities for train- 
ing apprentices in their craft have opened the doors of 
their schools to returned soldiers, while others have 
organized teaching workrooms and conduct large classes 
of the disabled. Employers large and small have shown 
their eagerness to cooperate in this work. Many have 
opened their shops to learners on favorable terms, and 
others have formed schools in which they provide in- 
struction in the various trades used in their shops. The 
national schools which before the war gav^e special 
training in business, the skilled crafts, or agriculture 
hav^e organized new courses for the disabled. These 
courses are shorter and necessarily less complete than 
the regular courses for young apprentices, but they 
enable disabled men to acquire suflScient working knowl- 
edge of the trade to obtain employment in it. 

Since a majority of the wounded poihts are peasants 
whose homes are in tiny villages far from factories and 
shops, it has been necessary for most of the schools to 
teach simple village trades. The movement cit\nvard 
has to be combated in France for the sake of the nation's 



164 THE DISABLED SOLDIER 

future prosperity, and schools have therefore had to 
guard against teaching trades which would take men 
away from their homes on the land and concentrate 
them in industrial centers. The peasant who can no 
longer follow the plow or swing the scythe must not be 
uprooted from his old surroundings, but must be taught 
a trade in which he can earn a living for himself and his 
family in the old neighborhood. Almost every French 
village can use a tailor or a shoemaker, usually a saddler 
and harness-maker, too, and a basket-maker who can 
supply the particular kind of container used for the 
local products. There are also always pots and pans 
to be mended — a tinsmith is needed for that — and there 
are countless calls for a carpenter. These then are the 
trades most frequently taught in the provincial schools. 
Of them all the most popular with the men is shoe- 
making. In practically every school throughout the 
country one finds more pupils in the shoemaking section 
than in any other manual trade. In explanation of this 
fact one of the most successful re-educators in France 
has written that the men are attracted by the prospect 
of being able to set up their shop in their own house, so 
that between nailing on new soles they can run out and 
hoe their potatoes or cultivate a few grapes. In many 
parts of the country where the peasants wear wooden 
sabots or the clogs with wooden soles and cloth uppers 
known as galocheSy sabot and galoche-making share the 
honors with shoemaking. Tailoring does not attract the 
returned soldier, and though there is a demand for good 
workmen in the trade many schools are giving up their 
classes. All of these trades with the exception of car- 
pentry have been found within the capacities of men 
with leg amputations and have in some instances been 




A Nevj Way to Sharpen a Scythe. With two arms gone and 
one eye missing, this French poilii can earn his living 




I 



1 



1- 



1^ 



-4 



^1 

•2 s 



ALLIES ON THE CONTINENT 165 

mastered by men with lesser arm injuries. A carpenter 
with a leg amputated can do bench work but cannot 
mount scaffoldings. Since carpentr>^ is, however, always 
an arduous trade and beyond the strength of many 
wounded men, it has been replaced in many schools by 
cabinet-making. 

Favorite courses with men who wish to practise a 
trade in the city are those which make them mechanics 
and machinists. Peasants with a mechanical turn have 
opportunities to become farm mechanics, or men quali- 
fied to operate and repair tractors and other agricultural 
machinery. In the old days there would have been little 
enough demand in the French countryside for skill of 
this sort, but the war has changed all things, even the 
unchanging methods of the French farmer, and now in 
an effort to replace the labor of the peasant lads who 
have died on the battle line, an increasing number of 
tractors are being imported from America and put to 
work upon the fallow fields. The schools teach men not 
only to operate them but also to repair them and even 
to replace parts upon the forge or lathe, for many ma- 
chines will go into remote districts where they have 
never been seen before. 

A large number of men who before the war worked 
in the wood, leather, or metal trades are being trained 
to make artificial limbs. This is a growing industry in 
France, and the need for skilled workmen is acute. Two 
good hands are as a rule required for it, but the loss of 
a leg need not be a handicap. Indeed, it may even be 
an asset, for who is so well fitted to improve old models 
or to make new inventions as the man who is conscious 
of the defects of his own artificial leg? Disabled French 
soldiers working in school shops have devised many 



166 THE DISABLED SOLDIER 

useful appliances and are now turning out large quanti- 
ties of limbs for their wounded comrades. 

Toy-making has been selected as a good trade to teach 
disabled soldiers for two reasons — because there is a 
general wish to see an industry formerly monopolized by 
the Germans built up in France and because it contains 
openings for one-armed men. At the Ecole Joflfre in 
Lyons one-armed men cut out the flat toys by means of 
a band saw, turn others in the round at a lathe, and 
paint the droll faces and quamt costumes which make 
French toys a delight to old as well as young. 

One-armed men are also employed at the Ecole Joffre 
in making paper boxes and paper bindings. Some proc- 
esses in bookbinding are beyond their powers, but they 
can do all the work on notebooks, pads, and ledgers. 
They do not work as quickly as other men, but by 
specializing at one machine they can acquire sufficient 
proficiency to earn a fair wage. The school hopes to 
place many of them as foremen or examiners, positions 
which do not require constant manual effort. 

Work with a lathe or band saw, in the experience of 
several schools, yields a good return to men who have 
lost an arm. French varnishing has also been found to 
be suited to them. Pottery is another possible trade 
for men so handicapped. There are innumerable seated 
trades in which men with leg injuries can do a full day*s 
work, but there are comparatively few in which the 
one-armed can compete with uninjured employees. 

Since so many of the manual trades are closed to 
them, the majority of the one-armed in French schools 
are being trained for office positions. They are taught 
bookkeeping and business usage, stenography and type- 
writing, and afterwards placed in banks, business 



ALLIES ON THE CONTINENT 167 

houses, and government offices. Often common school 
subjects, such as writing, French composition, arith- 
metic, and geography, are included in the course, in 
order to supply the deficiencies of the soldier's previous 
education or to brush up long-forgotten learning. Some 
general schooling is also given to the men learning trades, 
usually for an hour after dinner in the evening. 

Another kind of office work in which badly disabled 
men have achieved real success in France is industrial 
design or drafting. Men who have lost the use of one 
arm, even those who have suffered amputation of the 
arm, have been able to acquire skill in the work and 
afterwards to obtain good positions as tracers or de- 
tailers. Many of these have had no previous training 
in work of the kind, often no technical background at 
all, though machinists and men in the building trades 
incapable of the activity and strength required in their 
old work have found it particularly interesting. In 
schools where the draughting course has been most suc- 
cessfully developed, several branches of design are 
taught, so that a pupil can specialize in that for which 
he has most talent. In the municipal school for disabled 
soldiers at Paris, for instance, the course includes 
draughting for machinery, building construction, furni- 
ture, architecture, and landscape gardening. 

Sometimes twenty or more different trades are taught 
in one school in order to meet the needs of men with all 
sorts of different injuries and from many different locali- 
ties. Such a variety of opportunity is to be found in 
the larger schools of Paris and Bordeaux, where from, 
two to three hundred pupils can be cared for at one 
time. There are, however, a number of smaller schools, 
situated in regions where there is a predominant local 



168 THE DISABLED SOLDIER 

industry, which teach only the one trade. Thus at 
Saint-Claude, a small city in the Jura which is the center 
of the diamond-cutting industry of France, the school 
organized by the townspeople for disabled soldiers 
teaches nothing but diamond-cutting. The school at 
Oyonnax teaches only the different branches of the 
celluloid industry, thereby fitting men to go into the 
numerous celluloid factories in the vicinity. The na- 
tional school of clock-making at Cluses near the Swiss 
border is adding to the number of renowned clock and 
watch-makers of that region. In Paris there are special 
schools for novelty jewelry-making, glass-blowing, tapes- 
try-weaving. 

In the early days of the re-education movement, when 
schools to teach new trades to the disabled were springing 
up all over the country, the importance of training for 
the farm was not sufficiently recognized. A few schools 
taught truck gardening with perhaps poultry or rabbit 
raising, but there was no thorough-going effort to induce 
the wounded farmer to go back to his old useful work of 
producing wheat or milk or sugar beets to feed the nation. 
When it was seen, however, that the shortage of farm 
labor was one of the most serious problems facing the 
country, the need was clear for training which would 
enable a disabled man to work on a farm and to profit 
from owning a farm. This training is now being pro- 
vided by the Minister of Agriculture in the existing 
agricultural schools and by some private associations in 
newly organized farm schools. An agricultural school 
for French mutiles is also being conducted by the Ameri- 
can Red Cross, which has recognized the urgent need of 
fitting the wounded to return to the land. 



ALLIES ON THE CONTINENT 169 

The first purpose of the instruction given is to show 
the unhappy, often hopeless farmer that he is still cap- 
able of hard outdoor work. Practice in the management 
of his artificial limb and in new ways of handling his 
old tools will do this for him and at the same time give 
him back his courage and revive his old interests. Some 
men go back to their homes after these first few weeks 
of readaptation, but others are persuaded to stay for a 
longer period. They are then taught modern methods 
of general farming, including scientific fertilizing, the 
prevention of pests, and the use of labor-saving machin- 
ery, or they take up the study of some branch of farming, 
such as butter and cheese making, sheep raising, or bee 
keeping. It is hoped that after this instruction men 
who before the war were but farm hands will have the 
requisite knowledge for managing a small farm of their 
own. The means of acquiring a small piece of land have 
been put within their reach by the recent passage of a 
law which enables disabled soldiers to borrow money 
from the agricultural banks at a very low rate of interest 
for the purpose of buying or improving agricultural 
property. The sum is small, being limited to ten thou- 
sand francs, but holdings are also small in France, and 
much can be raised on them by the intensive industry 
of the French farmer. Returned soldiers who are already 
proprietors will perhaps derive even greater benefit from 
the law, in that they will be able to re-stock their farms 
and buy new machinery, and so begin their new life 
with perhaps a fairer start than before. 

Mayor Herriot of Lyons — to whom can be attributed 
so much that is good in the French measures for the 
disabled — decided to provide free board and lodging for 
his pupils while they were learning their new trades, and 



170 THE DISABLED SOLDIER 

most of the other schools followed his example. The 
re-education school in France is therefore usually a 
boarding-school with dormitories and dining-halls as 
well as classrooms and shops. Whether trade training 
given under these conditions would appeal to our soldiers 
on their return from overseas is open to discussion, but 
the system is apparently admirably suited to the necessi- 
ties and disposition of the French mutile. By living in 
the boarding-school the pupil from outside the city 
enjoys cleaner quarters and a better chosen diet than 
he could obtain in the usual working-man*s boarding- 
house; he is less tempted to cut his classes or his shop 
work; and he comes into closer relations with his in- 
structors. These through their more intimate acquaint- 
ance with his problems are better able to help him over 
the difficulties and discouragements which are bound to 
beset him during the early period of his training. 

The discipline in the schools, though not military, is 
fairly strict, but the pupils seem to submit to it with 
entire good grace. They are usually required to wear 
a special uniform and they are in many places allowed 
to leave the grounds only on Sundays and the Thursday 
half-holidays. If a pupil breaks the rules, he may be 
warned and deprived of his leaves, but if he continues 
to show a bad spirit, he is simply sent away from the 
institution. The authorities want only sober, indus- 
trious men who will make the most of the opportunities 
offered to them. A man who imagines that he is there 
for anything but work soon finds that his place is needed 
for some more earnest pupil. 

While the boarding-school principle generally prevails 
in France, there are numerous day schools, the guild 
schools in Paris for instance, which have been very sue- 



ALLIES ON THE CONTINENT 171 

cessful in their teaching, and there has been some use of 
the apprenticeship system. The apprenticeship system 
trains men by placing them as learners in shops and fac- 
tories. It has some obvious advantages over the school 
method — it is more economical in that new workshops 
do not have to be fitted out; it offers the choice of an 
almost infinite variety of trades; and it allows the men 
to work and live under more normal conditions — but 
there is always danger that the instruction will not be 
so good. Too often an apprentice is treated simply as 
cheap labor and gets no chance to learn the different 
processes of the trade. At Tours, however, where the 
system has been put into practice rather more exten- 
sively than elsewhere in France, it has had excellent 
results. The director of the work at Tours, a citizen 
who gives his time, is a man of rare judgment in placing 
men and of untiring devotion in watching over their 
progress, by force of which qualities he has been able to 
overcome many of the usual obstacles to successful ap- 
prenticeship. Other dangers which everywhere lie in 
wait for the disabled man when he is first thrown on his 
own resources — discouragement, gambling, and drunken- 
ness — have been guarded against at Tours by housing 
and boarding together all apprentices without homes in 
the city. Many of the advantages of the boarding-school 
are in this way secured to the men, and there can be 
some supervision over their habits and leisure hours. 

In a boarding-school men receive their living and often 
their clothing and laundry as well as their instruction 
without cost to themselves. If they attend a day school, 
they receive from some aid society a small allowance, 
three or four francs a day, which is expected to provide 
them with the necessities of life. In addition, most of the 



172 THE DISABLED SOLDIER 

schools pay their pupils wages, a small sum at the begin- 
ning, which increases as the man's skill increases. Often 
these wages are paid out of the proceeds of the sale of 
the articles made by the pupils, the sum being divided 
among them in proportion to what they have done. At 
least a part of the money thus earned the men are ex- 
pected to save so that they will have the wherewithal 
to buy the tools and equipment they will need when 
they set up for themselves. The family of a man in 
training has either his pension, which is never touched 
by the school, or the separation allowance which they 
received while he was in the army. 

As has been said, the chief re-educational schools of 
France, with the exception of the national institute at 
Saint-Maurice, were originally financed by subscriptions 
from individuals plus grants of money from the city or 
department in which they were located. Later, as the 
very great national importance of their work was recog- 
nized, most of the schools received financial aid from 
the national government, submitting at the same time 
to government inspection. It then became apparent 
that there should be some government department which 
could efficiently oversee the work of the schools, co- 
ordinate their efforts, and work out a uniform system of 
re-education for the whole country. A bureau known 
as the National Office for discharged and disabled sol- 
diers was accordingly created, with headquarters at 
Paris and branch offices or committees in each of the 
eighty odd departments, or administrative districts of 
France. It is the duty of the departmental or local com- 
mittees to see that every returned soldier gets what he 
needs in training or employment; if facilities are inade- 
quate, then these committees should see that the needed 



ALLIES ON THE CONTINENT 173 

classes or schools or employment agencies are organized. 
The National Office itself is charged with giving a com- 
mon direction to the work and with seeing that the best 
interests of the miitiles are in every way served. 

Good jobs are easily found in France for disabled men 
who have been re-trained for work. In fact, most of the 
graduates from the French schools have secured better 
positions than they had before the war. They have 
usually obtained their positions through the school 
where they trained, or, if the school did not undertake 
any placement work, through the local employment 
office for discharged soldiers. A great many employ- 
ment bureaus for discharged soldiers were opened by 
unofficial aid associations during the first months of the 
war, but the work has now been mainly taken over by 
government bureaus under the control of the Minister 
of Labor. Local offices are now to be found in every city 
and town ; exchange agencies for these are located in the 
prefectures, or capital cities of the departments; and 
there is at Paris a clearing-house for all the agencies in 
the country. All agencies have been instructed that 
they should whenever possible settle men in the district 
in which they lived before the war and either in their 
old trade or in an occupation closely connected with it. 
They have also been warned to make sure that the situ- 
ations they offer are suitable ones for handicapped and 
often sadly shattered men. The industry in which a dis- 
abled man is placed should not be one with a slack 
season when the least efficient workers will be laid off, 
and the working and living conditions should be good. 
Above all, the individual should be really fitted for the 
position. There should be no placing of men in the first 
position that happens to turn up in the idea that the 



174 THE DISABLED SOLDIER 

employer's patriotism will make up for the workman's 
incapacity. These are surely sound principles and 
should be at the basis of all placement work for disabled 
soldiers. 

A very natural tendency on the part of employers to 
discriminate against disabled men because of the in- 
creased cost of workmen's compensation insurance when 
numbers of disabled are employed has been overcome 
by the passage of a new workmen's compensation law. 
This law provides that if an accident to a disabled soldier 
while at work was caused by his previous disability, the 
compensation shall be paid not by the employer but by 
the national government. And if the man's incapacity 
for work after the accident is due in any part to his pre- 
vious condition, only that part of the allotted sum which 
is compensation for the direct results of the accident 
shall be paid by the employer, the government being 
responsible for the rest. The government's share of the 
compensation is to be paid out of a fund raised by a 
tax on employers and insurance companies. Since acci- 
dent insurance premiums will therefore not be increased 
to the employers of disabled men and since employees 
are taxed whether they employ the disabled or not, there 
no longer exists this ground for discrimination. 

Belgian soldiers wounded in the terrible retreat from 
Liege to Dixmude were discharged from the hospitals 
in an even more broken and destitute state than their 
French comrades in arms. Frenchmen, all but those 
from the devastated districts of the north, had at least 
homes to which they could return. Their lot was piti- 
able enough in its helplessness and enforced idleness, 
but there was some comfort for them in the ministrations 
of their families and friends. Belgium, however, except 



ALLIES ON THE CONTINENT 175 

for the narrow strip of sand and marsh behind the bloody 
Yser, was all a devastated region; homes had been 
sacked and burned by the invader, families had been 
slaughtered and carried off into captivity. When a 
Belgian was of no more use in the army, he could be 
discharged, but he could not be sent home. He could 
only be turned adrift and left to work or beg his way 
along French or English roads. Often it happened that 
before men's wounds were barely healed, the hospitals 
where they lay were flooded by a new tide of wounded 
men from the front, and all who were able to leave were 
turned out. Belgian soldiers, therefore, were often unfit 
for work because they had not been able to secure the 
longer treatment which might have restored to them in 
some measure the use of injured joints and muscles. 

It is said that two of these poor fellows, their clothes 
in tatters, their feet through their boots, but their 
breasts covered with medals for distinguished bravery 
in defense of their country, stopped at a certain house in 
Havre and asked for food. The house was that of the 
president of the Belgian House of Representatives, 
M. Schollaert, who himself listened to the men's stories. 
Shocked by the situation which he was thus able to 
image, M. Schollaert took them in and immediately 
applied to the government for permission to provide a 
home and medical care for these and other destitute 
soldiers. The manor-house at Sainte-Adresse in which 
he placed them and the staff he organized for their 
physical reconstruction became the nucleus of one of 
the two great institutions now providing re-education 
for Belgian soldiers. 

The founder and director of this Depot des Invalides 
at Sainte-Adresse soon saw that he must add vocational 



176 THE DISABLED SOLDIER 

training to his program if he was to refit the men under 
his care for Hfe and work. Workshops of a primitive 
kind were therefore installed wherever there could be 
found a place for them in the neighborhood. The 
brush-makers were set at work in the stable, the carpen- 
ters in a hired shed, and the shoemakers in the parlor 
of a villa. Later when the Belgian government lent its 
aid to the work, all the shops and dormitories were 
gathered together in portable wooden barracks in a vast 
cantonment. 

Before the institution at Sainte-Adresse had passed 
through more than its earliest stages, the government 
realized that the disabled soldier problem could only 
be solved by more far-reaching measures. The first 
action then taken was the announcement by the Min- 
ister of War that soldiers who were unable because of 
their wounds to perform their former work would no 
longer be discharged at the end of their hospital treat- 
ment but would be sent to an institution where they 
could learn a new occupation. The next was directed 
at the men who had been previously discharged and 
who were now in distress in France and England. Agents 
of the Belgian government rounded up these men, re- 
voked all their discharge papers, and subjected them to 
new physical examinations. Those that were found suf- 
ficiently able-bodied to be of use in the auxiliary services 
were taken back into the army; the others, unless they 
had secured well-paid, permanent employment, were 
sent either to a military hospital for further treatment 
or to Sainte-Adresse for vocational work. 

It was then necessary to make the re-educational 
facilities of the nation — exiled though it was — adequate 
for training all men in the Belgian army who were or 



ALLIES ON THE CONTINENT 177 

might become incapacitated for their former occupations. 
To this end the government made grants of money to 
the institution at Sainte-Adresse and created the Belgian 
national school for disabled soldiers at Port-Villez. Both 
are on French soil: Sainte-Adresse just outside of Havre 
and Port-Villez about half way between Paris and 
Rouen. The two schools have a capacity for training 
over three thousand men. 

Men are now sent to Sainte-Adresse or Port-Villez 
directly from the base hospitals at Rouen. If they need 
re-education, they have no choice but to take it. The 
compulsory character thus given to their training has 
been accepted without dispute by Belgians, though in 
other countries the idea has always been strongly op- 
posed. Belgians have fewer counter-attractions in their 
lives than have other men. They are more cut off from 
the past, and they see no future until the invader is 
driven out. For these reasons, perhaps, they do not 
rebel at being kept in an institution and made to learn 
a trade. 

But though training of one kind or another is com- 
pulsor>% the individual can freely express his preference 
for this or that kind of work, and whenever he is not 
debarred by mental or physical limitations can take up 
the kind he desires. Often, however, a man who is cut 
off from his old occupation can fix upon no other, and 
the school authorities must then help him to choose. 
In this matter of choosing a trade — which is, in fact, 
one of the most important steps in the whole process 
of re-education — the Belgian schools follow a notably 
good course. Every man on his arrival undergoes a 
thorough physical examination, which determines what 
kind of work he is physically capable of and from what 



178 THE DISABLED SOLDIER 

he IS barred. This is followed by a mental examination 
designed to bring out the extent of his previous schooling 
and his general intelligence. Next, he is taken on an 
informal tour of the shops, during which he can talk 
with the workmen in the different trades and discover 
perhaps some latent taste. The several examiners then 
compare their notes on the man's aptitudes, talk over 
the matter with him very seriously, and finally place 
him in one of the shops. If after a week's trial the work 
appears to be unsuited to him, his case is opened again, 
and a new start is made. 

Rarely does it happen that there is no work suited 
to a man's tastes and capacities, for the Belgian schools 
teach a very great variety of trades. The woodworking 
trades, the metal trades, the leather trades, all branches 
of printing, various farming specialties, and numerous 
other callings — at Port-Villez, over forty in all — give 
the individual a wide field for choice. 

In most of the shops the aim is to produce salable 
articles as well as to teach the trade, but good teaching 
is never sacrificed for the sake of production. Large 
orders, for example, are filled for the army supply 
department, but whenever the foremen think it neces- 
sary to give greater variety to the men's work, there are 
interspersed private orders. No order is accepted unless 
it can be utilized for instruction. 

Good teaching is a harder problem in the re-educa- 
tional school than in a regular trade school owing to the 
fact that new pupils are arriving all the time instead 
of at the beginning of a term. To overcome this diffi- 
culty, the Belgian schools use an excellent system of 
group instruction. Recent arrivals in a shop are put 
together and started at the first processes of the trade 



ALLIES ON THE CONTINENT 179 

under the guidance of a more advanced workman. At 
regular intervals, since different beginners will inevitably 
progress at different rates, they are regrouped according 
to their abilities. In some shops there is a monitor for 
every four workmen. 

As a supplement to the practical work of the shops 
all the men learning trades receive some theoretical 
instruction. Through this they learn the principles of 
construction of their tools and machines, the properties 
and sources of their raw materials, how to determine 
the sale price of their products, and how to place them 
on the market. Wood and metal workers attend classes 
in draughting, not to become draughtsmen, but so that 
they may be able to read blue prints. In addition, 
every man receives some general schooling. 

Commercial courses are given to fit men for civil 
service and other office positions, and there is a normal 
course for those who wish to become teachers. 

After the Belgian government had so amply provided 
for the artisan and commercial classes among its dis- 
abled, it determined to complete its duty by giving to 
young men whose professional studies had been broken 
off by the call to arms an opportunity to continue their 
education. Since a university, unlike a trade school, could 
not be created overnight, these young men were sent to 
Paris, where they are lodged and boarded at the expense 
of the Belgian government while they study at the great 
Paris schools. The instruction has in most cases been 
made a free gift to them from the schools. Their books 
and . instruments have been furnished by the Belgian 
Minister of Arts and Sciences. 

As all men in the Belgian re-educational schools are 
still nominally soldiers, they receive besides their main- 



180 THE DISABLED SOLDIER 

tenance their soldiers' pay, but no pensions. If they are 
productive workmen, they also receive wages, a part of 
which is saved for them against their departure from 
the school. 

In Italy as in the other allied countries all aid for the 
disabled soldier is based on the new principle that it 
must be aid through work. The old idea of giving the 
disabled soldier a pension and some soft government 
post was in 1914 still strong in Italy, where the war of 
the Risorgimento had been followed by much the same 
kind of pension legislation and veteran preference as our 
Civil War. Soldiers crippled in the struggle for Italia 
irredenta confidently expected to be treated as were 
Garibaldi's veterans, and to receive some comfortable 
sinecure in the postal or telegraph system or at least in 
the government sale of salt or tobacco. The new idea 
has, however, prevailed, and in 1918 all wounded sol- 
diers in the Italian armies are offered something better 
than the means of living in idleness, namely, the chance 
to learn a useful trade. 

The Italian law is that all crippled soldiers shall 
remain in the orthopedic hospitals until they can profit- 
ably commence their re-education. They are then dis- 
missed from the hospital on a month's leave and allowed 
to visit their homes. At the end of the leave, unless they 
are plainly not in need of re-education or are too hope- 
lessly crippled to benefit from it, they must report at 
the nearest re-educational school. They are required to 
stay in the school only two weeks, not long enough of 
course to make more than a beginning at learning a 
trade, but long enough to understand what re-education 
Is and what benefits it holds out to them. They can 



ALLIES ON THE CONTINENT 181 

then make their own decision as to whether they wish 
to continue or to return to their homes. 

The schools of which the government now makes use 
in its scheme for universal re-education were founded 
by private means and remain under the management of 
local committees, but are controlled and in part sup- 
ported by the government. Thus in Italy as in France 
the work was begun by private initiative and only later 
coordinated into a national system. Government con- 
trol is exerted through an appointed National Board for 
the Assistance of Invalided Soldiers, similar to the French 
National Office. This Board inspects and superv^ises the 
work of the schools, grants charters to new committees, 
and revokes the charters of those that do not come up 
to the standard. 

The first local committee was formed at Milan, and 
the Milan school became the model for others as the 
Lyons school was in France. Rome, Florence, Naples, 
Genoa, Bologna, Palermo, V'enice, and other cities fol- 
lowed suit as soon as the growing interest in the new 
gospel had aroused the citizens. In most of the northern 
provinces the formation of committees has been spon- 
taneous, but public opinion has been slower in the south. 
In some regions the National Board has been empowered 
to call on the Mayors of towns to organize schools for 
district needs. It appears that unless the re-educational 
facilities of the country as a whole are increased, the 
law providing that all crippled soldiers shall spend 
at least fifteen days in a school cannot be put into 
effect. 

The outward surroundings of the schools have usually 
their full share of Italy's gracious charm. The buildings 
are often fifteenth century palaces which have been 



182 THE DISABLED SOLDIER 

donated to the committees, or they are ancient convents 
surrounded by gardens, or stately pubHc buildings front- 
ing on picturesque piazzas. Within, the atmosphere is 
formal and institutional. Hours for work and recreation 
are all carefully regulated, and the plan of work is in- 
elastic. Military discipline is enforced. At graduation 
there are usually speeches and prizes given either by 
the committee or by interested citizens of the town, for 
the naive Italian peasant has his interest greatly stimu- 
lated by such ceremonies. Every man receives also a 
certificate stating his fitness to follow a trade. 

While attending the school the men are supported by 
the government, that is, the government pays the school 
a fixed sum for their maintenance. The government 
also pays the men their regular soldiers* pay and gives 
their families the same allowances as when the men were 
in active service. The period of training during which 
the man and his family are thus supported is limited to 
six months, but the National Board, if it wishes, can keep 
the man longer at the school at its own expense. 

The courses in the Italian schools have been deter- 
mined largely by the needs and limitations of the pupils. 
Eighty per cent, of the invalided soldiers, ninety per 
cent, in some provinces, are peasants with no experience 
in trades and very often illiterate. The great oppor- 
tunity of the schools therefore has been to give these 
men a rudimentary education and in so doing to open 
up to them a new world. In many of the schools men 
are allowed to take up trade or business training only 
after they have completed the elementary and inter- 
mediate school courses. The business courses train the 
less intelligent among the pupils to fill such simple posi- 
tions as concierge or store clerk; men capable of more, 



ALLIES ON THE CONTINENT 183 

they fit to be stenographers, bookkeepers, and bank and 
office clerks. There are special courses for postal and 
telegraph employees which are very popular with the 
men since they lead to government positions, but open- 
ings in this direction are rapidly being filled, and a strong 
effort is now being made to divert men to the trades and 
to agriculture. 

The trades taught at Milan are carpentry, tailoring, 
shoemaking, basketry, leather work, wood inlay and 
wood carving, the making of wooden shoes, saddlery, 
broom and brush making, and mechanics. In general 
the same trades are taught at the other institutions, 
although critics have pointed out that training which is 
profitable at Milan, an industrial center, is little suited 
to the rural southern provinces. Not even a tailor or 
a shoemaker is greatly in demand in primitive villages 
where the inhabitants go ragged and barefoot. The 
chief need in these regions is for agricultural education, 
and the schools are now being urged to organize farm 
training wherever possible. At Palermo, where agricul- 
tural courses were started early, extremely worthwhile 
results have been obtained from instructing the ignorant 
and conservative Sicilian peasant in modern agricultural 
methods. Knowledge of this kind will economically 
more than compensate a wounded peasant for his phys- 
ical handicap. 

In some districts in Italy famous old handicrafts still 
flourish and bring high pay to a skilled worker. A 
cripple can very well work at such a craft if his injuries 
are not of the arms or hands, and so a number of the 
schools have courses in these skilled trades. Several 
teach bookbinding, which in Italy is still regarded as an 
art; others, fine cabinet-making or art pottery. Florence 



184 THE DISABLED SOLDIER 

has its famous toys, and Venice teaches the old Venetian 
arts of wrought iron and stamped leather. 

All the schools have employment committees which 
are assisted in their work by a central placement office. 
Many of the men of course go back to their own village 
and set up their shop in their house. In cases where 
they go to the large cities employers have been found 
generally anxious to help: the Electro-Technical Society, 
for example, has made a list of the positions it can offer 
to cripples and the injuries compatible with them. 
Private firms are obliged to reinstate their employees 
crippled in the war if the employees can pass the required 
physical tests. Accident insurance companies are not 
allowed to increase their rates to employers of war 
cripples unless more than a certain proportion of the 
employees are disabled. 



KINGDOM AND DOMINION 185 

CHAPTER XIV 

KINGDOM AND DOMINION 

When England sent her first '^contemptible little army" 
to the continent in defense of the violated rights of 
Belgium, it was followed not alone by more Britishers 
but by troops from every corner of the globe. In every 
dominion of the empire troops were enlisted to * 'fight 
for the right*' as the home country had seen it, and were 
dispatched to the front as fast as circumstances allowed. 

Great Britain and every one of her dominions, in con- 
sequence of their heroic stand for the benefit of civili- 
zation, have had to face the problem of the returning 
disabled soldier. In the solutions attained by these 
commonwealths, dealing as they have with Anglo-Saxons, 
men of similar traditions, habits, and impulses as our- 
selves, the United States must find peculiar interest 
and derive unusual profit from the showing of their ex- 
perience. 

When the first British disabled began to return to the 
streets of London, there was scant provision for their 
care. 

Now to every British soldier who lies in the hospital 
ward three possibilities are open — a visit from the dark- 
winged Messenger, a period of convalescence and the 
buckling on again of the sword for another thrust at the 
Hun, or ''Blighty," the old familiar haunts, an economic 
crutch in the shape of a pension, and a job suited to his 
physical limitations. As surely as the stricken deer 
seeks the familiar glades so does the discharged warrior 



186 THE DISABLED SOLDIER 

turn his halting steps to the sheep downs of the south 
or the smoky towns of Lancashire, the heather hills of 
Scotland, the mines of Cardiff, or the long, long way to 
Tipperary. 

If we could visualize the procession of maimed and 
disabled men in mufti as it leaves the discharge depot 
we would see it melt away into the economic horizon of 
every portion of the United Kingdom, to carry to each 
county, borough, and town the problem of the care of 
the disabled man as a legacy of the Great War for the 
stability of those free institutions the Anglo-Saxon prizes 
above life or sound limbs. And in each and every dis- 
trict he will find that provision has been made to con- 
tinue his medical treatment, choose for him an occupa- 
tion suited to the abridgement of his powers, and induct 
him into it after proper training. Should he be in doubt 
as to his rights under the new and unusual laws of the 
realm, the Local Pensions Committee stands ready to 
secure his rights, succor his family, and educate him to 
surmount the handicap the enemies of civilization have 
laid upon him. And this, not because England thought 
this out as the best way to care for her disabled heroes, 
but because it chimed in with her way of doing things 
in the past. Local government has always been a cher- 
ished prerogative of the English commonwealth since 
the days of the petty kingdoms. A representative gov- 
ernment may sketch its plans in the large, but the English 
community must be given a free hand in filling in the 
local details. So when the Disabled Sailors* and Soldiers* 
Committee reported to Parliament in 1915 that **the 
care of the sailors and soldiers, who have been disabled 
in the war, is an obligation which should fall primarily 
upon the state'* and that body passed the Naval and 



KINGDOM AND DOMINION 187 

Military War Pensions Act in 1915 to provide for ''the 
care of officers and men disabled in consequence of the 
present war/' the plan proposed to commit the disabled 
man to the care of a local committee of his own towns- 
men. To be sure, later developments of the plan necessi- 
tated modifications of this scheme in the interests of co- 
ordinated measures for the economic welfare of the 
realm, but this is essentially the genius of the English 
plan — local responsibility for bringing the opportunities 
afforded by the government to the door of each dis- 
abled man. 

Specific instances of like care were not wanting. The 
Incorporated Soldiers' and Sailors' Help Society, which 
was established under royal patronage at the close of 
the South African War, had sought to aid the ex-service 
man in finding employment by furnishing him with the 
name of a * 'friend" in each parish or ward throughout 
the empire. The Old Age Pensions scheme of the state 
was administered by local committees in every borough 
and urban district having a population of 20,000 or over. 
The necessities of the families of the enlisted men had 
long been looked after by the Soldiers' and Sailors' 
Families Association by a ramification of local commit- 
tees composed largely of clergymen and ladies of leisure 
in all parts of the country. 

It was quite natural, therefore, that Parliament should 
look to a local committee to take the hand of the disabled 
man and lead him all the way back to a life of productive 
and contented activity. It was thought that the neces- 
sities of each man could best be assessed and provided 
for by a committee of his townsmen familiar with the 
conditions that environed him and his family. The 
soundness of this principle cannot be questioned, and 



188 THE DISABLED SOLDIER 

while it may not make for uniformity it at least has the 
advantage of intimacy. It is the recognition of a prin- 
ciple, expressed many times in Parliamentary debate 
and charity organization, that in dealing with individ- 
uals in widely differing stations in life and with peculiar 
necessities, a human element must somehow be provided 
which the uniformity of governmental regulations does 
not permit. The human element — a quick sympathy, 
an intimate knowledge of a disabled man's circumstances, 
a way to help unfamiliar to rules of a bureau — this can 
be supplied best by the local committees. 

And so England followed the blazed trail of private 
philanthropic organizations and established Local Pen- 
sions Committees in every county, county borough, and 
urban district having a population of not less than 
50,000. The committees are responsible to the Ministry 
of Pensions, which establishes rules and regulations to 
secure uniformity in the provisions they make for the 
men committed to their care. The appointment of these 
committees is largely left to the local authorities, but in 
general they must include some women, some represen- 
tatives of labor, and members of the Soldiers* and Sailors' 
Families Association, and of the Soldiers' and Sailors' 
Help Society. A salaried secretary appointed by the 
Ministry of Pensions is a kind of liaison officer between 
the local body and the central office. 

The duties of the Local Pensions Committee are 
broadly sketched in the instructions of the Ministry of 
Pensions: *'The local committee should regard them- 
selves as responsible for all discharged men of this class 
{i. e,y disabled) living in their area. They should make 
it their business to get in touch with every such man, 
whether or not he has obtained employment or occupa- 



KINGDOM AND DOMINION 189 

tion since his discharge, and see that the treatment or 
training which his condition needs is secured for him 
when he needs it. . . . It is vitally important both 
in the man's interest and in that of the Nation that any 
case which needs either treatment or training should be 
taken in hand at once. Local committees must not be 
content with dealing only with the men who happen to 
present themselves to them for assistance; they must 
see that they have information as to the condition of 
all discharged pensioners in their areas, and make it a 
point of getting in touch with them directly they are 
discharged." 

The committee is to be guided in its decisions in regard 
to suitable training for a man by several considerations. 
His previous occupation must have w^eight. The pro- 
posed occupation must be suitable to his age, disable- 
ment, and physical condition. If any recommendation 
as to his training has been indicated on his notification 
of award for pension or by a hospital visitor, this must 
be considered. Not least of the factors entering into a 
solution of the problem before the committee must be 
the opportunities for a living wage in the occupation 
chosen for him. 

It must be quite clear that if the local committee were 
left to its own devices wholly in choosing an occupation 
for the man the result in the field of industry might be 
disastrous. The influx of a large number of disabled 
men into a particular occupation without some standard 
of training might arouse antagonisms that would be un- 
fortunate. This necessitated some rulings by the central 
office in the interests of coordinated effort. Both the 
employers of labor and the work people must have some 
voice in the matter, especially in a country whose labor 



190 THE DISABLED SOLDIER 

organization has made such strides. The necessary ma- 
chinery was provided by the Ministry of Pensions co- 
operating with the Ministry of Labor. Trade Advisory 
Committees have been appointed for most of the prin- 
cipal trades. Each committee is composed of an equal 
number of employers and work people. It is the duty 
of each committee to advise the Ministry of Pensions 
as to conditions under which the training of men in that 
trade can best be given, the best methods of training, 
the suitable centers for it, and in general to secure uni- 
formity in the training. The numerous reports already 
issued contain a valuable fund of information regarding 
the trade from the viewpoint of the man who is physi- 
cally handicapped. The analysis of an industry with 
the man with abridged powers in view is a phase of in- 
dustrial efficiency which the war has developed. Never 
again can the old laissez faire policy of allowing the 
handicapped man to stumble along the industrial road 
undirected and unassisted prevail. Society cannot again 
close its eyes to this waste of human efficiency and the 
heartbreak of the man whose work powers are unappreci- 
ated because of some physical abridgement he has suffered. 
The question of wages to be paid to a disabled man 
will always be a vexing problem. Where a disabled man 
can do his full stint of the work and compete with his 
normal fellows, he should plainly receive the equal wages 
whether he is receiving a pension or not. But there are 
grounds for debate when the man is physically unable 
to perform a full task either in hours or output. The 
inevitable tendency will be for the employer to depre- 
ciate the man's ability. The exploitation of the disabled 
man, especially when he is receiving a pension, is feared 
by organized labor, jealous of its wage standards. An 



KINGDOM AND DOMINION 191 

eflfort has been made to provide machinery for obviating 
this difficulty. The Ministry of Labor has set up in the 
principal industrial centers advisory" wages boards com- 
posed of representatives of employers and work people 
and three members of the Local Pensions Committee. 
This committee is to advise the local committee, or an 
employer desirous of employing a handicapped man, 
what would be an equitable wage in his particular case, 
taking into consideration the man's physical capacity 
and the current rate of wages for the industr>^ in that 
locality. The question of a man's pension is not to be 
taken into account. The committee acts purely in an 
advisory^ capacity, but it is hoped by these means to 
provide against the exploitation of cripples or the lower- 
ing of trade standards. 

It is the duty of the Local Pensions Committee to 
provide facilities for the training of its disabled ex-service 
men. It was soon seen that the training facilities of a 
larger area than that within the jurisdiction of most 
local committees must be made available if the variety 
of occupations demanded were to be provided. So Joint 
Advisory Committees, composed of the representatives 
of local committees, were formed in 1916 to arrange com- 
prehensive schemes for utilizing the facilities for tech- 
nical education within whole counties or groups of 
counties. Twenty-two of these joint committees were 
formed in the United Kingdom. They surveyed the 
technical facilities in their respective districts and syn- 
dicated them in the interests of all. 

For many years the British government has aided 
local technical schools, and the result has been a surpris- 
ingly large number of institutions w^here one or more 
trades are taught. These trades cover the principal 



192 THE DISABLED SOLDIER 

industries of the country. The number of technical 
schools in the industrial counties of Lancashire and 
Yorkshire is particularly noticeable. Both of these 
counties formulated ambitious schemes for the training 
of disabled men in every variety of industry pertaining 
to the soil, the mine, the factory, and the sea. The co- 
operation of all the principal technical schools in the 
training of disabled men was secured. The offer of facili- 
ties seems to have greatly exceeded the demand. 

Not only have the technical schools been utilized for 
re-education but many men have been trained directly 
in workshops and factories. The plan advocated by 
several of the trades advisory committees provides that 
a man shall spend part of his time at a school and part 
of his time in actual work in a factory or workshop. By 
this means a balance is maintained between the theo- 
retical and the practical. 

It must not be supposed that every man returns to 
his home district absolutely unprepared for an altered 
industrial career. Many of the men avail themselves of 
the opportunities afforded by the workshops connected 
with the hospitals in which they have spent their period 
of convalescence. Early in the history of the war cura- 
tive workshops were established in the hospitals of Roe- 
hampton and Brighton, whither men who have suffered 
some amputation are sent. Major Mitchell, the director 
of one of the leading technical institutes, was chosen to 
direct the courses. The therapeutic value of manual 
work has been fully recognized, and many a man, invited 
to busy himself in a workshop with the tools of a man's 
job ready to his hands, has not only found a stimulus 
to the functional activity of injured members but has 
actually learned a trade while waiting for nature to 



KINGDOM AND DOMINION 193 

heal his wounds and the government to furnish him 
with an artificial Hmb. Not every man avails himself 
of the opportunities offered him in the hospital and 
must look to his local committee to furnish the oppor- 
tunities for training he slighted or to supplement his 
training by continuation courses. 

Upon his discharge from military service the disabled 
man is granted a pension based upon the degree of 
physical disability he has suffered and is free to return 
to his home locality. His future lies within the advisory 
jurisdiction of his Local Pensions Committee acting for 
the Ministry of Pensions. He may choose to live a life 
of inactivity depending for a scanty subsistence upon 
the slender stipend granted him by the Ministry of 
Pensions. He may accept a job ready to his hand, 
because of acute industrial conditions caused by the war, 
from which he is likely to be ousted by the return of able- 
bodied men upon the demobilization of the army. Or, 
he may accept training at the expense of the state and 
become a skilled worker with better prospects of con- 
tinued employment when normal times return. The 
good sense of the man and the persuasiveness of the 
local committee will largely determine what course he 
is to pursue. 

If he elects to take training he will receive, during the 
time required for his re-education up to six months, his 
total disability pension together with a family allowance, 
all necessary fees will be paid for him and at the end of 
his course he will receive a bonus for each week of 
training. The state cares for both himself and his 
family during his period of re-education. At the end of 
his course he will be fortified against the exigencies of 
the future by the wages he can earn at a skilled trade 



194 THE DISABLED SOLDIER 

and the regular pension to which his injuries entitle him. 
It is expressly stipulated that his pension shall never 
suffer diminution because of his increased earning 
capacity. Many disabled men are now receiving from 
this dual source larger incomes than they enjoyed before 
they entered the service of their country. 

The demand for disabled men who have received 
training has been so great that no difficulty has been 
found in finding employment for them. The admirable 
system of state labor exchanges provides the facilities 
for placing disabled men in industry and their services 
will be in still greater demand when peace returns and 
conditions of employment are greatly altered by the 
return of men from the front. 

While the preparation of disabled men to enter into 
competition with their normal fellows seems to promise 
the best results on the whole, still it must be recognized 
that many men with severe physical limitations must be 
provided for in special institutions under favorable work 
conditions. Specialized machinery and carefully planned 
team work can make productive units of badly handi- 
capped men with whom the average employer is not 
willing to bother. Large provision for this class of men 
has been made by the Lord Roberts' Workshops, which 
are being multiplied in different parts of the country. 
Some ten years before the war the Soldiers' and Sailors' 
Help Society opened workshops in London to provide 
employment for disabled ex-service men for whom it 
was extremely difficult to find work. The work has been 
greatly expanded since the war, and the enterprise has 
taken the name of the nation's military idol, who was 
greatly interested in the project. Toy-making, with the 
many processes involved, has been found a suitable in- 

















^B|l 





Still in the National Service. Making submarine fittings 
and thus continuing to help defeat the enemy 




A Wage-Earner Once More. The loss of a right arm does not prevent 
this British soldier from doing useful work in a laboratory 



KINGDOM AND DOMINION 195 

dustry for many types of disability, and the enterprise 
has been successfully conducted on a sound commercial 
basis. The plans of the society contemplate facilities in 
the eleven workshops in different parts of the country 
for the accommodation of between four and five thou- 
sand men. 

Great Britain's colonies have, one by one, followed 
the trail blazed by the pioneers of re-education and are 
now admirably equipped to offer training and employ- 
ment to the disabled soldiers of their own forces. Canada, 
AustraHa, New Zealand, South Africa, and India all are 
now prepared to receive from the battlefields those whom 
they sent forth, to fit again for civilian pursuits those 
whom war has maimed. 

Great credit is due our neighbor on the north for her 
promptness in making provision for her disabled men. 
When the ambulance transports landed the first few 
bands of disabled Canadians at the clearing depots in 
Halifax, St. John, or Quebec, there were medical boards 
to examine them, and hospitals on wheels to carry them 
comfortably to their military districts. After a short 
stay at home the soldiers are expected to report back to 
the military convalescent hospitals named in their passes. 
Then their physical rehabilitation begins. 

In the hands of the Invalided Soldiers' Commission, 
an outgrowth of the Military Hospitals' Commission, are 
the duties of re-educational work and vocational training 
in Canada, whether provided for men undergoing treat- 
ment in military hospitals or after discharge. 

Those Canadians who have given an arm or a leg in 
service are fitted with artificial limbs in Toronto, where 
a government limb factory has been established. The 
fitting of limbs is done in a branch of the Military Ortho- 



196 THE DISABLED SOLDIER 

pedic Hospital at North Toronto, and local branches for 
fitting have recently been established at several points. 
The leg made in Canada is of the standard American 
type. For men who have been discharged from the hos- 
pitals, artificial limbs are provided free, and arrange- 
ments have been made by which the government will 
keep them in repair. 

To those of her men who are prevented by their dis- 
abilities from resuming their former occupations, Canada 
offers special training in a new trade at the expense of 
the Invalided Soldiers* Commission. While the soldier 
is still in the hospital, his future is discussed with him 
by a vocational officer, and a plan of action is decided 
upon. The man comes up before the Disabled Soldiers' 
Training Board, which consists of the district vocational 
officer, a special medical officer, and a representative of 
the local employment organization dealing with the 
problem of placing returned men in industry. This 
board determines the man's eligibility for training under 
the regulations and the occupation for which the man 
is to be trained. The place of training, length of course, 
method, and cost are determined by professional mem- 
bers of the staff of the Invalided Soldiers' Commission. 
The plan is then recommended to the authorities of the 
commission at Ottawa. Should there be no objection, 
the man's re-education is begun. 

The disabled soldier is given an opportunity to change 
his course of training, if it is found that the original 
choice was unhappy. The man approved for re-educa- 
tional training is given a pension and a vocational allow- 
ance, also an allowance for his dependents, so that he is 
relieved of financial worry while he is undergoing in- 
struction. 



KINGDOM AND DOMINION 197 

At a typical Canadian school of re-education, the men 
attend as day pupils, receiving instruction in machine- 
shop practice, gas-engine operation, automobile me- 
chanics, electric power station practice, railroad or com- 
mercial telegraphy, surveying, architectural drafting, the 
manufacture and repair of artificial limbs, shoe-repairing, 
moving picture operating, steam engineering, heating 
plant operation, electrical work, civil service, commercial 
courses — bookkeeping, accountancy, stenography, type- 
writing, secretarial work for municipalities — cabinet- 
making, sanitary inspection, meat and food inspection, 
to be instructors in vocational subjects, wood-working, 
and machine operation. On a prairie, several miles out 
from the school, men are taught to operate gas tractors, 
with which they plow up virgin soil, and do a hard day's 
work as they would under actual employment. There 
are also classes in mathematics, English, and civics. 

The best schools and courses will not benefit the dis- 
abled trainee unless he has the right teachers and unless 
there is a real bond of friendship between the individual 
man and the vocational officer. The teachers sought 
are skilled men with wide experience, rather than peda- 
gogues. Those most desired are competent men who 
have seen military service overseas, physically handi- 
capped civilians, or civilians not eligible for military 
service. Instructors are not in uniform, but serve as 
civilians. 

Some men are placed for training in factories, under a 
modified apprenticeship system. Their instruction is 
carefully supervised by a visiting inspector, and the 
progress made is recorded and checked up. This method 
of instruction is meeting with more and more favor in 
Canada, and the results have been exceedingly inter- 



198 THE DISABLED SOLDIER 

esting. The men thus placed receive no wages — unless 
the employer voluntarily pays them as the training 
progresses — but receive from the government the same 
benefits as to pension and training allowance as the men 
re-educated in schools. 

. By arrangement with the various provinces, it was 
agreed that the Commission reserved the right to place 
in employment graduates of the re-educational system, 
while men able on return to Canada to re-enter civil life 
without training were to be placed by provincial com- 
missions. There has been put into force since the begin- 
ning of 1918 a system of placement and follow-up for 
men completing courses under the Invalided Soldiers' 
Commission. Complete records show where men are 
employed and the wages they are earning. Some of the 
figures, for example, comparing wages before enlistment 
and after re-education show that the increase in earning 
power of the first hundred men graduating in Montreal 
— pension payments not being taken into account — aver- 
aged fourteen per cent. 

Australia calls her work of refitting disabled soldiers 
for civil pursuits ''repatriation.*' At first, as in England, 
private agencies assumed the burden of caring for re- 
turned fighters. Later, when Australians began to come 
back from the battlefields in increasing numbers, the 
government recognized its duty to them by passing in 
September, 1917, the Australian Soldiers' Repatriation 
Act. This act placed the control of repatriation in the 
hands of a commission consisting of seven members. In 
the capital city of each state local boards were created to 
act as agents in carrying out the plans of the commission. 

The mere passage of the measure did not assure the 
carrying out of the scheme for restoring disabled men to 



KINGDOM AND DOMINION 199 

self-support. At first, a soldier was registered at the 
repatriation office only when he applied there for help. 
Under the act, the first task of the repatriation com- 
mission, according to Senator Millen, would be to register 
the condition and requirements of all returning soldiers, 
either on the transports or before they left England. 
This early registration would give the commission some 
idea of the number of men they had to deal with, their 
needs, wishes, and qualifications. 

For those whose disabilities prevent them from secur- 
ing employment without re-educational training, the gov- 
ernment plans to provide preliminarv' training in curative 
workshops attached to the hospitals, and then more 
advanced training. Such work has been launched in the 
hospitals at Sydney and Melbourne. 

To meet the needs of the first amputation cases, 
Australia was forced to import artificial limbs from 
England, an unsatisfactory^ procedure at best. Later, the 
Surgeon General of the Defense Department established 
limb factories in Melbourne and Sydney. To start the 
first factor}^ in Melbourne, an American expert was 
called in. 

Under the act, a number of Local Committees were 
created to act as local agents for the Department of 
Repatriation in regard to placing of men in employment. 
Various labor branches were formed to carr>' on the 
routine work of the ordinar>^ private labor agency, and 
to inform the department as to returned soldiers in their 
districts wanting work and as to vacancies requiring 
men to fill them. Great effort is being made by the 
Repatriation Department to list employers who prom- 
ised to re-employ returned soldiers and to canvass the 
field for employers who are willing to take on disabled men. 



200 THE DISABLED SOLDIER 

The regulations under the Repatriation Act, effective 
April 8, 1918, authorize the creation in each state of a 
Soldiers' State Industrial Committee, for the purpose of 
facilitating the training of men in private industrial 
establishments. The former committee has power to 
decide disputes arising from decisions made by the latter. 

A Soldiers' District Industrial Committee, consisting 
of a chairman appointed by the Minister, two represen- 
tatives of the employers in the trade of the trainee, and 
two representatives of the union covering the trade or 
calling of the trainee, have these powers: (1) to consider 
opportunities for employment of soldiers or their depen- 
dents; (2) to decide after trial as to the suitability of 
applicants for particular callings; (3) to assess the effi- 
ciency of the trainee after the commencement of his 
training; (4) to re-assess the trainee's efficiency every 
three months; (5) periodically to review the facilities 
for training in workshops and technical schools; (6) to 
deal with disputes between persons entered for training 
in private workshops and the employer, in particular 
disputes arising as to what is the ruling rate of wages in 
any industry; and (7) to have power when necessary 
to call for and take evidence. 

In his speech before the Senate on May 2, 1918, the 
Honorable E. D. Millen, Minister for Repatriation, 
pointed out that since it was not possible to find employ- 
ment for all disabled men in the ordinary channels of 
industry, it would be necessary to find "reserve employ- 
ment." An arrangement was made with state govern- 
ments by the federal authorities to grant the states as a 
gift an amount of money to make up the deficiency 
caused by the employment of such men as could not 
give the full day's work in return for the full day's wage 



KINGDOM AND DOMINION 201 

of an able-bodied worker. For instance, if the full wage 
paid be 10s. per day, and the returned soldier em- 
ployed can earn no more than 8^. in the day, owing to 
some little incapacity, the difference of 25. will represent 
the measure of his inefficiency, and the Repatriation 
Department will make that good by a gift of the amount 
to the state governments concerned. Several state 
governments have made arrangements to employ men 
on such terms in afforestation. 

Those of New Zealand's men who have gone to the 
front are assured of the best possible provision for their 
successful re-entry into civilian life upon their return. 
The whole problem of the returned New Zealander is in 
the hands of the Discharged Soldiers' Information De- 
partment, which has established a network of local com- 
mittees that assume the responsibility of finding suitable 
employment for the men in his own community. 

Especial effort has been made to get in touch with 
every returning soldier to ascertain his situation and 
his needs. Representatives of the Department board the 
incoming transports, or arrange to secure from the mili- 
tary authorities on board ship the necessary data con- 
cerning each man. This information is recorded on a 
card in the central register of the Returned Soldiers' In- 
formation Department, and word is sent informally 
regarding the home-coming man to the community to 
which he is to return. 

The duty of interviewing the discharged soldier is 
often delegated to local police officials, who are cau- 
tioned to make their inquiries sympathetically and tact- 
fully. The interviewer takes with him a blank report 
to fill out and also a circular of information for the soldier. 

If a man does not require the department's assistance, 



202 THE DISABLED SOLDIER 

the interviewer obtains his signature to that effect. 
Many of the men do not require assistance, as they may 
have business or farms to return to, or may have suffi- 
cient private means. Others may have obtained em- 
ployment or promises of employment. 

The man who desires employment is instructed to 
get in touch with the local committee in his home 
district. 

For disabled men who cannot return to their former 
occupations free tuition has been offered in various fields. 
On the state farms, men are taught various branches of 
agriculture. At Lincoln College, Wellington, where free 
scholarships are offered in scientific agricultural training, 
those who desire clerical training are instructed by the 
New Zealand Society of Accountants. In addition to 
classroom teaching, correspondence courses are main- 
tained for those who cannot attend in person. 

At Wellington Technical College instruction is pro- 
vided for disabled men in building construction, decora- 
tion, painting, carpentry and joinery, plumbing, machine 
work, jewelry making, metal work, plastering and model- 
ing. Other centers provide different courses of training. 

To remove any financial difficulties for men desiring 
to take training, the government decided to grant to 
ex-soldiers attending classes a maintenance allowance of 
not more than one pound a week, irrespective of pension 
payment. This allowance is conditioned upon the man's 
good conduct, regular attendance, satisfactory progress, 
and suitability for the chosen trade. 

Despite New Zealand's persevering efforts to provide 
suitable training for her disabled men, the results have 
not been encouraging, for comparatively few men have 
availed themselves of the opportunities offered. The 



KINGDOM AND DOMINION 203 

results In obtaining employment for disabled men, 
however, have been exceptionally successful. This may 
be due in some part to the abnormal demand for labor 
in New Zealand at the present time and to the desire 
on the part of most of the returned soldiers to get back 
as quickly as possible to remunerative and productive 
employment. 

A school of re-education in India is indeed a new thing 
under the sun. To teach disabled soldiers of the Indian 
forces such trades as motor mechanics and tailoring in 
order to make them self-supporting must appear won- 
derful to us who have been accustomed to regard the 
hordes of mendicants in India as a natural element in 
that country's curious make-up. 

At Bombay is one of the most picturesque schools in 
the world. Queen Mary's Technical School for Disabled 
Indian Soldiers it is called, founded over a year ago by 
Lady Willingdon, wife of the Governor of Bombay. 
Here there are hundreds of India's returned fighters, 
men from all ranks and castes, working zealously under 
competent instructors who teach them trades that range 
from poultry raising and farming to tailoring, motor 
mechanics, engineering, carpentering, motion picture 
operating, and oil engine driving. For six months or 
more these olive-skinned, curly bearded trainees work in 
the shops until they are ''graduated" and sent out to 
trades at which they can earn from twenty to one hun- 
dred rupees a month, or about six to thirty- two dollars. 
Not a great income, perhaps, but sufficient in view of 
the fact that the average man in India can live com- 
fortably on about six dollars a month. 

The building itself is at Byculla. It is splendidly 
appointed with sitting-rooms, dormitories, and work- 



204 THE DISABLED SOLDIER 

shops, and is surrounded by beautiful grounds where the 
pupils take their exercise or spend pleasant hours 
conversing or reading. Spacious verandas afford them 
ample space for games and amusements. In the well- 
ventilated dormitories each man has beside his bed his 
own lockup in which he keeps his personal belongings. 

Queen Mary's School affords the men every oppor- 
tunity to take their training in comfort and without 
financial worry. Clothes, bedding, and food are supplied. 
To those who have to come from a distance return railway 
tickets and traveling expenses are given. When a man 
finishes his course, he is supplied free with a set of tools 
for his trade. 

Trained men are placed in Bombay and other indus- 
trial centers in workshops and factories; with regiments 
or the army clothing department as tailors; in the 
mechanical transport service as chauffeurs; in the gov- 
ernment dockyards, ordnance factories, and arsenals as 
turners, fitters, machinemen, engine drivers, and am- 
munition box makers. 

Artificial limbs are furnished to cripples at one of the 
hospitals in Bombay, while in hospitals at Dehra, Dun, 
and Mussoorie reconstructive medical treatment is pro- 
vided for the benefit of disabled men. 

In addition to the employment department of the 
Queen Mary's Technical School there have been formed 
at the various centers in India bureaus that take care of 
the problem of placing disabled men in suitable employ- 
ment. 

In Richmond Park, Surrey, England, on a magnificent 
twelve acre site, stands the South African Military 
Hospital, especially built for permanently disabled South 
African soldiers. The South Africa Union, without facili- 



KINGDOM AND DOMINION 205 

ties for carrying on the necessary work of re-education, 
found it advisable to establish on British soil a hospital 
and training center for the disabled men of her own forces. 

Nothing is left undone to make the disabled soldier 
feel at home in his new quarters in Richmond Park. 
Corridors and patients' departments of the hospital are 
designated after familiar places and streets in South 
Africa. Thus, the main entrance opens into ''Adderley 
Street," leading into ''Market Square'* in Cape Town, 
while the corridors are named * 'Commissioner Street," 
"Maitland Street," and "Sunnyside." The hospital 
buildings were designed to resemble South African 
colonial timber-framed dwellings of a type familiar to 
the disabled man. The day rooms are named after well- 
known clubs, "The Ramblers," "The Wanderers, "and 
"The Dustpan." The majority of the beds have been 
endowed with money collected by school children in 
South Africa. 

One of the hospital buildings is a large concert hall, 
used at times for church services, for entertainments for 
the patients, and for classes in typewriting, bookkeeping, 
shorthand, and motion picture operating. Adjacent to 
the concert hall and established in connection with the 
hospital, are the practical workshops or vocational train- 
ing classes. Here disabled soldiers are taught to become 
metal turners and fitters, tool makers, brass finishers, 
coppersmiths, tinsmiths, engine drivers and attendants, 
acetylene welders, electrical fitters for power, light, tele- 
phones, and bells, cinematograph operators, electrical 
testers, meter readers, dynamo and switchboard attend- 
ants, sub-station and accumulator attendants, motor car 
drivers and repairers, carpenters and joiners, cabinet- 
makers, bootmakers and boot repairers, clerks, store- 



206 THE DISABLED SOLDIER 

keepers and timekeepers, bookkeepers, accountants, 
salesmen, secretaries, and managers. The vocational 
training staff consists of nine experienced instructors 

I under an educational organizer. The workshops are 

registered by the city guilds and the classes are inspected 
periodically by experts. 

When a man enters the hospital he is classified under 
one of three headings: (1) likely to become fit for further 
military service ; (2) doubtful if he can be fitted for fur- 
ther military service; or (3) unlikely to be fit for further 
military service. If he falls under one of the first two 
classes, he is given curative treatment only, to return 
him to active service as soon as possible. If he comes 
under the third heading, his case is investigated to deter- 
mine whether he will require vocational training. If it 
is found that the does, he training is begun as early as 
possible. 

The hospital and vocational staffs cooperate as closely 
as possible, for it has been found that the interest of the 
disabled soldier can be stimulated in some type of work 
long before he is well enough to leave his bed. 

j According to Lieutenant-Colonel Thornton: **Under 

' the South African scheme the men start earlier than in 

any other institution in the United Kingdom, as this 
hospital is the only primary hospital which has Voca- 
tional Training Classes established in connection with it.*' 
This statement strikes the keynote of the South African 
plan. The fact that work is going on about him tends 
to hearten the disabled man ; he is led to believe that he, 
too, can learn a trade. His training is begun gradually, 
under strict medical supervision. As soon as he is able 
to sit up in bed he is given typewriting or some light 



KINGDOM AND D O M I X I O X 207 

recreational work to do. This fosters the desire to con- 
tinue a course of training. 

The injured man is not compelled to take the training. 
He is advised by the doctor and by the vocational staff 
to attend the classes, but there is no penalty if he refuses. 
The choice of a career is settled upon at a conference of 
a doctor, the educational organizer, and the patient 
himself. The disabled man's own inclination, his physical 
disability and his suitability for the calling from medical 
and educational standpoints, are the determining factors 
in deciding his career. 

It is the rule at the South African Military Hospital 
that no man is kept a day longer than is necessary for 
his medical treatment. After his discharge he is kept as 
an out-student, and can receive further medical treat- 
ment as an out-patient. 

Upon discharge from the hospital, the men are not 
discharged from the army, but are kept as Union soldiers 
in hostels close to the hospital, and continue their training 
in the hospital workshops. The men are uniformed and 
subject to military discipline. A man may or may not 
undergo training as an out-student just as he chooses, 
but if he does take the training he must obey military 
orders. 

' Most of the students acquire sufficient training at 
Richmond Park to ensure them good livelihoods in 
South Africa, but wherever possible they are placed in 
workshops in England for several weeks prior to their 
embarkation so that they may get practical experience 
under actual working conditions. During their stay at 
Richmond Park the men receive, instead of pay or 
jDension, certain allowances from Union funds. It has 
been estimated that over ninety per cent, of those for 



i 



I 



208 THE DISABLED SOLDIER 

whom re-education would be appropriate undertake the 
training. 

The problem of reinstating the returned man in civil 
life in South Africa has been placed by the Union govern- 
ment in the hands of the Central Committee of the 
Governor General's Fund, and the whole Union has been 
divided into districts with a local committee in charge 
of each area. On these committees rest the responsibility 
for finding employment for returned soldiers. 

When a man is committed to the workshops, a full 
report is prepared as to his previous employment, 
physical disability, and the trade for which he is to be 
re-educated. This is sent to the Union government with 
copies for the committee for the area in which the man 
desires to live upon return to South Africa. Copies of 
progress reports on each case are sent from time to time 
to these committees, so that they have complete infor- 
mation well in advance and should thus have little diffi- 
culty on his return in finding for him suitable work. 
In fact, students are often notified prior to their return 
that there has been found for them employment upon 
which they can enter immediately after their arrival 
at home. 



ACROSS THE FIRING LINE 209 

CHAPTER XV 

ACROSS THE FIRING LINE 

Prepared as she was for war, so also was Germany pre- 
pared for the consequences of war. At the outbreak of 
the war, she had of all other countries laid the most solid 
foundation for the care of the crippled soldier. The 
German national Federation for the Care of Cripples is an 
organization of long standing. There had been devel- 
oped, during half a century's experience, fifty-eight crip- 
ple homes, under private auspices, ranging in size from 
six to three hundred beds. Some of them were already 
taking adults as well as children, and they had among 
them 221 workshops, teaching 51 trades. In addition, 
there were sanatoria and re-educational workshops for 
industrial cripples under the employers* accident insur- 
ance companies ; there were orthopedic hospitals operated 
by municipalities, and there were trade schools and 
employment bureaus under various government auspices. 
All these resources accumulated in peace time for the 
rehabilitation of cripples were mobilized immediately 
after the outbreak of the war — almost simultaneously 
with the military mobilization. Eight days after the 
outbreak of hostilities, the Empress, at the instance of 
Dr. Biesalski, Germany's leading orthopedist and secre- 
tary of the national Federation for the Care of Cripples, 
addressed to existing institutions for the crippled a letter 
pointing out the necessities ahead and urging them to 
open their doors and provide facilities for the treatment 



210 THE DISABLED SOLDIER 

and training of disabled soldiers. To this all the homes 
immediately consented. Dr. Biesalski undertook a tour 
of Germany and visited the principal cities urging the 
formation of voluntary committees for the care of war 
cripples. The immediate result was the formation of 
volunteer committees in many cities and of larger ones 
in some states and provinces. At the present time, 
Germany is thoroughly covered by a network of such 
organizations. A local committee usually comprises 
representatives of the municipality, of the military dis- 
trict command, the accident insurance association, the 
Red Cross, the women's leagues, the employers, the 
chamber of commerce, the chamber of handwork, and 
the labor unions. In the fall of 1915, a national com- 
mittee was formed with the object of coordinating the 
work and making investigations and plans for the future. 

There are four stages in the treatment of the disabled 
soldier: (1) medical treatment; (2) provision of artificial 
limbs and functional re-education ; (3) vocational advice 
and vocational re-education; and (4) placement. Of 
these activities, the first two are controlled by the im- 
perial military authorities and are conducted on uniform 
lines. With regard to vocational and economic rehabili- 
tation, on the contrary, there is no general direction given 
by any central authority; the re-education schools are 
of varying types and most unevenly distributed; the 
work is in the hands of local and private or semi-private 
agencies; it is done mostly by volunteers and is not even 
supervised by the imperial government. 

However, in spite of the absence of any general system 
of organization, there is a complete unity of purpose and 
the work is everywhere carried on in accordance with 
certain universally accepted and officially sanctioned 




The Enemy Conserces Man Povjer. Disabled 
German at work with a draw knife 




At Work Again — With Four Artificial Limbs. Germany sees to it 
that her disabled soldiers are prepared for self-support 



ACROSS THE FIRING LINE 211 

principles. These were formulated by Dr. Biesalski in 
this way: 

1. No chariU', but work for the war disabled. 

2. Disabled soldiers must be returned to their homes 
and to their old conditions; as far as possible, to their 
old work. 

3. The disabled soldier must be distributed among 
the mass of the people as though nothing had happened. 

4. There is no such thing as being crippled, while 
there exists the iron will to overcome the handicap. 

5. There must be the fullest publicity' on this subject, 
first of all among the disabled men themselves. 

The possibilit\' of rehabiHtation is accepted as a creed 
by all the institutions working to this end, it is put in 
practice, and the statement is that in ninet>' per cent. 
of the cases the desired results are attained. 

There is a fairly complete network of orthopedic homes 
distributed all over the empire. Their number has been 
put at about two hundred. They are all under military 
discipline. The time of treatment for a man in the ortho- 
pedic hospital is from two to six months. Men are kept 
here until they are ready to go back to the army or are 
pronounced definitely unfit for service. Even if they are 
so unfit, the war department does not discharge them 
until they are pronounced by the physician physically 
fit to go back to ci\'il life. 

The best hospitals are excellently equipped. Com- 
plaints have been made, however, that the remote hos- 
pitals have ver\' incomplete arrangements and that the 
great demand for orthopedists leaves some places un- 
supplied. 

More and more emphasis is being placed on physical 
exercise as a means of bringing disabled men back to the 



212 THE DISABLED SOLDIER 

standard. The plan is that a man shall begin very 
simple but systematic physical exercises even before he 
is out of bed. These are gradually increased until finally 
he has two or three hours a day under a regular gymna- 
sium instructor. Games and outdoor sports are found 
to have an immense therapeutic value, both psycho- 
logical and physiological, as compared with medico- 
mechanical treatment. Thus we find, at the different 
hospitals, as part of the regular regime, ball playing, 
spear throwing, bowling, shooting, quoits, hand ball, 
jumping, club swinging, and swimming. Finally, though 
the hospitals do not attempt to train a man to a trade, 
many of them have attached workshops for purposes of 
functional re-education. There is great emphasis placed 
on the fact that even this occupational therapy should 
be really useful and should lead the patient direct to some 
practical occupation. 

All artificial limbs are furnished and kept in repair by 
the government. The government has prescribed maxi- 
^ mum prices for prostheses of different types. Otherwise 

^ there is no official supervision. No standard pattern is 

prescribed, and the matter is left to the doctors and en- 
gineers of the country. The result is an immense stimu- 
lation of activity. The magazines are full of descriptions 
of new prostheses recommended by doctors and manual 
training teachers from all parts of the country. At an 
exhibition of artificial limbs, held at Charlottenburg, 
there were shown thirty kinds of artificial arms and fifty 
types of artificial legs in actual use. 

The principle now thoroughly accepted is that the 
prosthesis should reproduce not the lost limb but the 
lost function. It should not be an imitation arm or leg, 



ACROSS THE FIRING LINE 213 

but a tool. The standard of merit is the number of 
activities it makes possible. 

Re-education in Germany goes on at the same time as 
the medical treatment. This has two causes. First, 
there is the strong conviction among all cripple welfare 
workers that results can be obtained only by getting 
hold of a patient at the earliest possible moment of con- 
valescence, and second, the fact that, since the govern- 
ment does not pay anything towards re-education, it is 
more economical for the care committees to attend to 
it while the men are in the hospitals and thus save them- 
selves the expense of maintenance. 

The first civilian function in the care of the war cripples 
is vocational advice. The local care committee usually 
appoints vocational advisers, which appointments have 
to be sanctioned by the local military authorities, who 
control the visits to the men in the hospitals. As soon 
as a soldier is well enough to be visited, the committee 
sends a representative to get full data on his experience 
and his physical condition, and then advise him as to 
re-education or immediate return to work. The prin- 
ciple is fast held to that a man must, if humanly possible, 
go back to his old trade, or, failing that, to an allied one. 

The trade training is given while the men are still in 
the military hospital, beginning, in fact, as soon as they 
are able to be out of bed. The workshops are maintained 
by the local care committees ; they can be located either 
in the hospital, or at an outside point to which the men 
go every day. The first plan is followed by but a few 
of the larger institutions; in most instances there are 
no workshops maintained at the hospitals. The local 
care committee may utilize the local trade schools. 
There are excellent facilities for this, since every town 



214 THE DISABLED SOLDIER 

has at least one trade school. Some representative of 
the educational authorities generally serves on the local 

I care committee and the schools are eager, in any case, 

to offer free instruction. German magazines are full of 
advertisements of free courses for war cripples, offered 
by schools of the most varying kind, public and private, 

I from agricultural and commercial schools to professional 

schools and universities. On the other hand, in a large 
town, with a number of hospitals, the committee may 
create a school of its own. Thus, in Diisseldorf, for 
instance, where there are fifty hospitals, the committee 
has taken possession of a school building equipped with 
shops and tools and given twenty courses open to men 
from all the hospitals. 

It is planned that none of the courses shall take more 
than six months, the maximum time for hospital care. 
These short courses are intended for men of experience 
who need further practice in their old trade or in an 
allied one. If a man needs further training after this 
short course, he becomes the charge of the local care 
committee, which supports him while he attends a tech- 
nical school or pays the premium for apprenticing him 
to a master workman. 

A special effort is being made to return to the land all 
who have any connection with it, such as farmers, farm 
laborers, and even hand-workers of country birth. All 
the hospitals which have any land give courses in farming 
and gardening for their patients. It is estimated that 
there are several hundred such hospital farms, small or 
large, operated by the wounded. In addition to this, 
there are definite summer farm courses at agricultural 
schools and universities, which are free to cripples. 



ACROSS THE FIRING LINE 215 

There are in the empire ten regular agricultural schools 
for war cripples. 

Since the one-armed man has one of the gravest handi- 
caps, special arrangements have been made in several 
places for his training. The purpose of these courses for 
the one-armed is to accustom the soldier to exercise the 
stump and the remaining member, performing the daily 
duties such as eating, washing, dressing, tying knots, 
using simple tools, and the like. This is a preliminary 
to specialized trade training, and the process is said 
usually to require about six weeks. 

An essential feature of the course is left-handed writing 
for those who have lost the right arm, not only for men 
in preparation for clerical work but for others as well. 
This training banishes to a marked degree the feeling 
of helplessness and likewise gives the hand greater flexi- 
bility and skill. German teachers have made a scientific 
study of this question and state that left-handed writing 
can be made as legible and characteristic as right- 
handed. Samples of left-handed writing from Nlirnberg 
show excellent script after from twelve to twenty lessons. 

Left-handed drawing, designing, and modeling are 
often added subjects of instruction. Men with clerical 
experience are taught to use the typewriter, sometimes 
using the stump, sometimes a special prosthesis, and 
sometimes with a shift key worked with the knee. 

All the schools for one-armed put great emphasis on 
physical training. In the school at Heidelberg, under a 
regular gymnasium instructor, the men do almost all the 
athletic feats possible to two-armed men. 

There is no uniform machinery for the placement of 
war cripples. The care committees, while interviewing 
the man in the hospital, also get in touch with his former 



216 THE DISABLED SOLDIER 

employer. Sometimes a position is thus secured even 
before the man has started his training, and the latter 
is then adapted to the requirements of that particular 
position. But it is not always possible to place a man 
with his old employer. Some of the larger care com- 
mittees run employment bureaus of their own. Others 
turn over to some other agency the man who cannot be 
taken back to his old position — usually to the regular 
employment bureaus. Germany has a system of public 
employment bureaus supported by the municipalities. 
The bureaus in each state or province are united under 
a state or provincial directorate, and the directorates in 
an imperial federation. Some of these had, before the 
war, special divisions for the handicapped, and others 
have established them since the outbreak of hostilities. 
Employers' and workmen's associations are of consider- 
able assistance in the placement of war cripples, especially 
the Federation of German Employers' Associations, which 
has been recently formec} for this particular purpose, and 
the many master guilds of handworkers. There are also 
a number of agencies due to charitable or private ini- 
tiative. 

Finally, there are open to war cripples a very large 
number of positions in government service. The imperial 
government has promised that all former employees of 
the railways, postoffice, and civil service will be re- 
employed, if not in their old capacity, in a kindred posi- 
tion. These men are to be paid without consideration 
of their pensions. The postoffice department has decided 
to give all future agencies and sub-agencies in the rural 
districts to war cripples, provided they are fit for the 
positions and want to settle on the land. Many city 
governments make efforts to take in cripples. There are 



ACROSS THE FIRING LINE 217 

reserv^ed for cripples a number of employments under 
the war department, which through its recently created 
welfare department attempts also to develop placement 
activity wherever there is no ver\' active local care com- 
mittee, publishing twice a week a journal which lists 
positions open for war cripples. 

Both in Austria and in Hungar>', re-education is ob- 
ligatory and entirely controlled by the government. The 
respective functions of the military^ and the civil authori- 
ties, with regard to the care of the disabled, have been 
delimited as follows. The military- authorities provide 
the wounded with the first medical assistance, bear the 
cost of manufacturing and repairing artificial limbs as 
long as the patient stays in military' serv'ice, meet the 
cost of the treatment in non-military institutions, keep 
the wounded under control until recovery of earning ca- 
pacity' or until discharged as an invalid. After-treatment 
and vocational re-education are controlled jointly by the 
military and civil authorities. Placement is entirely 
under civilian auspices. 

The civilian part of the work is controlled by the 
Ministry of the Interior. However, in view of the great 
variety of linguistic and economic conditions in the em- 
pire, the Ministry has entrusted the care of invalids to 
the several provincial governments. In the capital of 
each province a provincial commission was created, for 
the purpose, among other things, of providing medical 
care and vocational re-education for war invalids of the 
province, and of creating the necessary^ machinery for 
placement, to administer which an official employment 
bureau has been created at every provincial capital. 

The largest Austrian institution for the care of war 
invalids is the so-called Reserve Hospital No. 11, in 



218 THE DISABLED SOLDIER 

Vienna. It comprises both an orthopedic hospital and 
training school. The hospital, which is excellently 
equipped, receives wounded soldiers whose wounds have 
been completely healed, and gives them reconstructive 
treatment. At the same time those who require pros- 
thetic appliances are trained in using them. 

After having completed the preliminary orthopedic 
treatment, every patient is assigned to a workshop. The 
workshops were at first established in a public school. 
But later a garden city was created, consisting of forty- 
two barracks, with a hundred men in each. The shops 
are now distributed among these barracks. 

Altogether about thirty trades are taught, mostly small 
handicrafts, such as can be carried on in small rural local- 
ities. The most important subjects of instruction are 
the following: woodwork (cabinet-making, turning, car- 
pentry), metal work (locksmithing, blacksmi thing, braz- 
ing, electrical work), bookbinding, basket-making, paint- 
ing, masonry, plastering, leather work (harness-making, 
purse-making, orthopedic appliances) , tailoring, and shoe- 
making. In addition to the manual trades, there are 
courses in bookkeeping, typewriting, arithmetic, and 
drawing. A course in agriculture is likewise given. 
There has been put at the disposition of the hospital a 
private estate, on which practical farm training in agri- 
culture is carried on under the direction of a physician 
and of a one-armed teacher. 

The first object of the re-education is always to return 
the man to his former trade, and, according to report, 
this result is attained in all but one case in twenty. 
Whenever the man can satisfactorily be restored to his 
former occupation, or when he has to be adapted to some 
less arduous work in the same line, his re-education is 



ACROSS THE FIRING LINE 219 

completed in the hospital school. But in the case of men 
being trained for a more skilled position in their own 
trade, or being taught an entirely new vocation — espe- 
cially the young soldiers who have never before had any 
industrial training — the courses given in the hospital 
schools are purely preparatory. Their purpose is to com- 
plete the functional restoration of the man, to find for 
him the most suitable occupation, and to accustom him 
to the use of his prosthesis. The specialization in skilled 
trades is left to other institutions, mainly to the regular 
vocational schools, which, through the cooperation of the 
Ministry of Public Works and of the various trade asso- 
ciations, offer special facilities for the training of men 
graduated from the hospital schools. 

The schools for invalids are under military control, but 
their administration is jointly civilian and military. Be- 
sides the ''medical director," w^ho is a member of the 
medical corps, there is a ''technical director," appointed 
by the Ministry of Public Works. These two officials 
act cooperatively as vocational advisers. 

The patient leaves the institution only when he is able 
to return either to the army or to his former occupation 
in civil life. In the latter case, he is not discharged until 
the hospital finds for him regular employment. In pro- 
curing employment, the hospital cooperates with the 
public employment office of Vienna, to which it details 
its own physicians, and a representative of the Ministry 
of Public Works. In the case of independent landowners 
or craftsmen, the hospital, before discharging them, 
makes inquiry to ascertain whether their prospective 
income is sufficient to their support. A register of all 
men discharged is kept by the hospital, and their place of 
employment and earnings are recorded from time to time. 



220 THE DISABLED SOLDIER 

The general tendency in Austria has been to establish 
large size institutions, on the Vienna model, and to locate 
them in principal cities, of which there are relatively few 
in Austria. By the end of 1915, institutions for crip- 
pled soldiers existed in Prague, Reichenberg, Troppau, 
Teschen, Graz, Cracow, Linz, Mehr-Ostran, and in some 
of the other large industrial cities. 

In Hungary, provision for disabled soldiers was organ- 
ized under several decrees issued in September, 1915. 
The work was put in charge of a Royal Office for the Dis- 
abled. The decrees provide that orthopedic appliances 
shall gratuitously be supplied. Re-education of disabled 
soldiers in their former occupation or a new one is ob- 
ligatory. The treatment and re-education are not to last 
more than one year. 

Special re-examination commissions were established 
at Budapest, Pressburg, Kolozsvar, and Zagreb, the chair- 
men and members being appointed by the Premier from 
medical and industrial circles. Invalids refusing to use 
prostheses, to submit to the treatment, or to take ad- 
vantage of the re-education offered, must appear before 
these commissions. Those who persist in refusal, in spite 
of the findings of the commission, forfeit all or part of 
their claim to a pension, excepting only those who have 
been in active military service for ten years or more. 

The Office for the Disabled, in collaboration with the 
War Ministry, keeps record of all soldiers incapacitated 
for military service and requiring medical care. It con- 
trols all hospitals for the treatment of disabled soldiers, 
all training schools, all shops manufacturing prostheses 
and artificial limbs, and all agricultural and industrial 
training institutions. It supports and supervises all pri- 



ACROSS THE FIRING LINE 221 

vate institutions caring for the disabled, and also manages 
the employment service. 

The institutions under the control of the Office for the 
Disabled are officially divided in three classes: (1) insti- 
tutions for medical care; (2) shops for the manufacture 
of prostheses; (3) schools for invalids. 

The men are assigned to the different medical institu- 
tions by the military authorities. They are received and 
discharged by the director, upon report by a commission 
of officials of the hospital. 

All the medical institutions were created anew. Or- 
ganization began at Budapest with four hospitals for 
4,500 patients; by the middle of 1916 there was accom- 
modation for over 10,000 in the hospitals of that city 
alone. In addition to those at Budapest, similar insti- 
tutions were established at Pressburg, Kolozsvar, Kassa, 
and several other cities. 

Private or commercial initiative failed to provide an 
adequate supply of artificial limbs. The Office for the 
Disabled, therefore, established shops for the manufac- 
ture of prostheses at the metal trades schools of Budapest 
and Pressburg. The work is done either by invalids or 
by soldiers detailed by the military authorities. In the 
spring of 1916 there came into being a permanent state 
factory for the replacement and repair of artificial limbs. 

Among the schools for the disabled, the largest is that 
at Budapest, which had 700 pupils at the beginning 
of 1916. Almost ninety per cent, of the pupils are 
peasants. The primary object of the re-education is to 
train independent craftsmen. The classes having the 
greatest numbers of pupils are those for shoemakers, 
tailors, harness-makers, cartwrights, locksmiths, and 
cabinet-makers. 



222 THE DISABLED SOLDIER 

Similar schools are found in Pressburg, Kassa, and 
Kolozsvar. Alongside of the vocational training, instruc- 
tion in reading and writing is given to illiterates. Those 
who have interrupted their elementary or highschool 
education are given an opportunity to continue it. In 
some of the schools instruction is also given in type- 
writing, stenography, and bookkeeping. 

At Budapest, at the Institute for the Blind, which has 
apprbximately 140 patients, blind soldiers are taught 
carpet-making, brush-making, massage, and the like. 

For the benefit of those men so disabled that they 
cannot be placed in regular factories or mercantile con- 
cerns, special cooperative shops have been created. 

It seems that while the work in its medical aspects 
ranks high, the vocational and economic aspects have 
been rather neglected. Thus, the regular vocational 
schools have not been utilized for the re-education of 
invalids; nor has any opportunity been taken of the 
different industrial organizations and trade associations. 
Very little has been done in the way of training in agri- 
culture. The employment service of the Office for the 
Disabled seems to be organized in a rather bureaucratic 
way, no cooperation has been asked of either local or 
trade organizations, and no vocational advisers are em- 
ployed. 

In spite of their preparation, in spite of their fore- 
warning, the Central Powers still have far to go in making 
adequate provision for the soldiers disabled in their grasp 
after world empire. 



FOR THE U. S. FORCES 223 

CHAPTER XVI 

FOR THE U. S. FORCES 

The situation of the United States with regard to making 
provision for the disabled soldier is perhaps slightly- 
different from that of the other belligerents. One of 
the principal causes of difference is the selective influence 
on the personnel of the military forces of the conscrip- 
tion law. 

This legislation has specifically exempted, temporarily 
at any rate, agricultural workers, highly skilled mechanics, 
and those who, because of their special qualifications, 
are necessary^ to the maintenance of the national interest 
at home. In Italy and France the situation with regard 
to the make-up of the army is vastly different. There 
we find almost all the able-bodied agricultural workers 
in the service, and battalions of highly skilled mechanics 
and experienced workmen in uniform. 

The problem of refitting for industry the disabled 
soldiers of the European forces is therefore very unlike 
that of the United States. Up to the present time the 
force sent to the front consists practically of men between 
the ages of twenty-one and thirty-one. This means that 
the majority of men disabled will not be highly skilled 
or long experienced in any occupation and thus will be 
more plastic from the vocational point of view. Past 
experience has in European practice been the main deter- 
minant of training for the future. It may be expected 
that in many of the American cases this will afford no 
definite criterion. Either the soldier may have entered 



224 THE DISABLED SOLDIER 

the service direct from school or college or if he has been 
at work for some time, it is likely to have been in a dozen 
different jobs of varying character. Many of the men, 
therefore, can answer definitely to no ^'former occu- 
pation.'* As has been found in Canadian experience, 
the soldier when asked his trade will report that for 
three months prior to the war he worked on a railroad. 
''Then you are a railroad man?'' is the question. *'No," 
is the answer, ^'for the two months before that I was in 
a cotton mill, and still earlier drove a delivery wagon 
for a local firm." In such a case past experience is almost 
a negligible factor, and the man may properly be re- 
studied vocationally in order that he may be trained in 
the skilled trade most suited to his qualifications and 
talents. 

An interesting experiment in vocational analysis and 
allocation has been carried out by the military authori- 
ties in classifying drafted men for special lines of army 
service. The new recruits have been given simple psy- 
chological tests prior to their assignment to work as 
radio operators, oxy-acetylene welders, linemen in the 
signal corps, drivers or mechanicians in the motor trans- 
port service, and so forth. The results have been en- 
couraging and the experience gained will undoubtedly be 
helpful in further vocational guidance of the men re- 
turning for discharge. 

In the general process, it is likely that many men who 
were previously undifferentiated as to occupation, who 
possibly looked forward to careers as clerks or general 
utility men, may be directed into skilled trades which 
will afford to them a much greater financial opportunity, 
and will contribute more largely to the national stability 
and efficiency. 



FOR THE U. S. FORCES 225 

The recent wave of interest In the United States in 
vocational education has put the country in better shape 
to deal with the instructional requirements of the dis- 
abled soldier than would have been the case ten years 
ago. Although not claiming facilities to compare with 
those afforded by the fine system of technical institutes 
in Great Britain, there are in practically every important 
urban community of America, one or more vocational 
schools. Industrial education is well provided for by 
schools, the first of which were founded by private ini- 
tiative but operated on a non-commercial basis. The 
later institutions have been established by local educa- 
tional authorities as part of the public school systems. 

Commercial education, to a noteworthy extent, is still 
in the hands of business colleges which are run as profit- 
making enterprises. But the work of many of them is 
efficient to a creditable degree. 

Agricultural education has been splendidly provided for 
by the agricultural colleges and experiment stations main- 
tained by the several states, with assistance, in some in- 
stances, from the national government. These institutions 
have the most modern equipment, expert teaching staffs, 
and the finest facilities for imparting a practical knowl- 
edge of agriculture. 

And finally, it must be recalled that practically every 
American university has industrial departments with 
shop equipment, which afford to students not only the 
theoretical, but also the practical, type of instruction. 
As the war goes on the universities will be drained of 
students, while the vocational schools whose regular 
pupils are of younger age, will tend to continue full. In 
Canada the university plants have been put to good 
use in the training of disabled soldiers. Even more 



226 THE DISABLED SOLDIER 

extensive facilities of this character are available in the 
United States. 

Prior to the entiy of America into the war there had 
been almost no provision for rehabilitation of the dis- 
abled adult. There had been several employment bureaus 
for cripples, in New York, Boston, Cincinnati, and Phila- 
delphia. These agencies had been struggling bravely, 
without recourse to training facilities, and with scant 
public support, to solve the economic problems of the 
disabled, and were attaining an encouraging degree of 
success. About five years previous there had been 
started, but later discontinued, a training school for 
crippled men. 

So in spite of the excellent foundation of general voca- 
tional education the United States, at her entrance into 
hostilities, stood practically without special facilities for 
the re-education of the disabled. The need of such 
special provision had been long recognized by workers 
with the handicapped and was repeatedly discussed in a 
special journal on cripples which was their organ. 

The first move to meet this need was taken the second 
month after America's declaration of war, when a public- 
spirited citizen offered to the American Red Cross funds 
sufficient to establish and maintain in New York City 
a training school for crippled men. While an original 
motive of the gift was a desire to make provision which 
might be helpful to the disabled American soldier, the 
school was started for crippled men in general, without 
distinction as to their civilian or military affiliation. 
Thus came into being the Red Cross Institute for Crip- 
pled and Disabled Men. 

It became soon evident that this organization had 
logical responsibilities much wider in scope than the 



FOR THE U. S. FORCES 227 

conduct of a local school of re-education. Legislation 
making government provision for the training of disabled 
soldiers did not appear on the statute books until fourteen 
months after the inception of hostilities, so for a con- 
siderable period there was no official agency to which 
to turn for information and advice. Yet there was wide 
interest in provision for the disabled soldier. To meet 
demands from the public for data on the organization, 
methods, and principles of re-education, as derived from 
experience abroad, and to provide a scientific foundation 
for the development of its own activities, the Institute 
initiated in July, 1917, a department of research. There 
was early issued a bibliography of the subject, followed 
by reports on activity in different countries, monographs, 
and translations, which have been freely distributed for 
the information of all interested in the subject. 

This Institute, which undertook at once the training 
of crippled industrial workers, has established courses in 
the manufacture of artificial limbs, oxy-acetylene welding, 
printing, motion picture operating, jewelry-making, and 
mechanical drafting. There are also departments of 
employment, industrial surveys, and public education. 

During the incubation of the national program the 
Red Cross Institute for Crippled and Disabled Men thus 
served as an experiment station and proving ground, 
and unofficially met demands upon it to the best of its 
abilit>\ 

In the formulation of the government plans there was 
considerable difference of opinion as to what authority 
or authorities should be charged with the responsibility 
of re-educating the disabled soldier. It was urged on 
the one hand that the entire task of rehabilitation in all 
its aspects should be entrusted to the Surgeon General 



228 THE DISABLED SOLDIER 

of the Army; on the other hand that it might be handled 
by the Bureau of War Risk Insurance — a government 
department administering family allotments and allow- 
ances and the new life and disability insurance, privilege 
of which was offered to men entering upon military 
service. A later suggestion advanced by the Council of 
National Defense was that re-education be entrusted to 
a commission under the War Department, made up of 
representatives of all the official and non-official interests 
concerned. Another proposal which was approved by 
a conference called by the Surgeon General of the Army 
at the instance of the Secretary of War, and which was 
embodied in the draft of a legislative proposal, called 
for an independent commission of five, composed of rep- 
resentatives of the Surgeon General of the Army, the 
Surgeon General of the Navy, the Treasury Department, 
the Department of Labor, and the Federal Board for 
Vocational Education. 

The Administration felt, however, the unwisdom of 
erecting more independent boards or commissions un- 
related to the regular executive mechanism. For this 
reason it was decided to fix the task on some already 
existing government department. The one designated 
in legislation introduced with executive approval, and 
later enacted, assigned the responsibility of providing for 
the rehabilitation of the disabled soldier and sailor to the 
Federal Board for Vocational Education, a body which 
had been created a year earlier to administer federal aid 
to vocational education by the states. The bill com- 
mitting this new function to the Board became law on 
June 27, 1918. 

Meantime, the Surgeon General of the Army had been 
establishing reconstruction hospitals for the intensive 



FOR THE U. S. FORCES 229 

treatment of physical disablement. In connection with 
each of these medical centers educational work had been 
undertaken — with three ends in view. The first was to 
provide to convalescent patients occupation for thera- 
peutic purposes; the second to provide educational 
opportunities during the period of invalidism to men 
who would be returned to the front or discharged without 
permanent disability; the third to train disabled men 
whom it was desired to retain in the military- organization 
for special or limited serv'ice. In carr^'ing out the two 
latter aims, the educational departments of the hospitals 
have entered w^ell within the vocational field. 

Important links in the militar>^ hospital chain are the 
reception hospitals at Fox Hills, Staten Island, N. Y.; 
at Ellis Island, in New York harbor; and at Newport 
News, Va. At these institutions there are first received 
from hospital ships or transports all soldiers invalided 
home from overseas. The men are classified as to treat- 
ment need and district of residence, and promptly 
''cleared'' to the appropriate institution. 

During the period of hospital or convalescent care 
the soldier has advantage of physical and occupational 
therapy administered by a corps of trained workers 
known as ''reconstruction aides" but more familiarly 
named "blue gowns" on account of their uniform. 

Classes in the various military hospitals have already 
been established. The subjects taught at General Hos- 
pital No. 6, Fort McPherson, Atlanta, Ga., for example, 
are motor mechanics, telegraphy, wireless telegraphy, 
typewriting, mechanical drafting, cabinet-making, car- 
pentry, harness repairing, poultry raising, reading and 
writing English, penmanship and bookkeeping, and 
printing. 



230 THE DISABLED SOLDIER 

When a candidate for discharge from the military 
forces is so disabled as to entitle him to compensation 
for disability, his case is discussed with him, while he is 
still in the hospital, by a vocational adviser of the Fed- 
eral Board for Vocational Education. He is told that 
the United States Government will train him free of 
charge for a new trade. It is entirely optional with the 
man whether he take advantage of this opportunity for 
training or not, but every influence is brought to bear 
to make his decision affirmative. 

After the disabled man is discharged from the hospital, 
he becomes a civilian and his dealings are with the 
Federal Board and the Bureau of War Risk Insurance. 

If the man decides to take a course of training, he is 
supported during the period of re-education through 
payment by the Bureau of War Risk Insurance of his 
compensation for disability or his former military pay, 
whichever is the greater. During this period the com- 
pulsory allotments and allowances to his dependents are 
continued just as if he were still in military service. He 
is given instruction that is paid for and supervised by 
the Federal Board for Vocational Education in one of 
the schools approved by that body. 

The Federal Board for Vocational Education has an- 
nounced that its provision of re-education will be made, 
so far as possible, through the use of existing schools, or 
by placement for training, under a modified system of 
apprenticeship, with manufacturing or commercial estab- 
lishments. Special institutions will be founded only 
where absolutely necessary. 

The Board is establishing district offices to decentralize 
the work, is making training arrangements for current 
cases, and is following up to their homes men who were 



FOR THE U. S. FORCES 231 

discharged from the army prior to the inception of re- 
educational activity, and who stand in possible need of 
training. Local offices are already in operation in New 
York, Boston, Philadelphia, Cincinnati, Atlanta, Wash- 
ington, D. C, New Orleans, Minneapolis, Chicago, St. 
Louis, Dallas, Denver, San Francisco, and Seattle. 

After training is complete, the re-educated soldier will 
be placed in a job by the Federal Board, acting, as pro- 
vided by the law, in cooperation with the United States 
Employment Service of the Department of Labor. The 
Board also includes in its placement function any man 
physically rehabilitated in an army or navy hospital, 
whether he be a candidate for retraining or not. 

The American Red Cross has offered to the govern- 
ment authorities the facilities of its extensive home 
service organization throughout the country. This 
service, directed by the Department of Civilian Relief, 
can help to align the family as an encouraging force 
behind the re-education program, can keep the family 
wheels moving smoothly during the period of training, 
can provide to the vocational officers much useful infor- 
mation on the home conditions and community record 
of any individual soldiers, can follow up the case after 
return to employment, and help in many ways to make 
• the re-education permanently effective. 

The actual work of putting the disabled American 
soldier back on his feet is still in its infancy, and many 
details still remain to be worked out in experience. But 
in principle, the United States has followed the best 
example of her Allies — in accepting provision for the 
disabled soldiers as a national responsibility to be met 
at public expense. It is clear that no American soldier 



232 THE DISABLED SOLDIER 

need be dependent upon the alms of charity for his re- 
habilitation. 

But the complete success of the work rests with the 
people of the United States — upon whether we sympa- 
thetically grasp and effectively express in our relations 
with the graduates of re-education the new spirit of 
dealing with the disabled — upon whether we sense the 
glory of restoring the ex-soldier's ability to earn his own 
living, or whether we continue the old temporary hero- 
worship and permanent pauperization. The self-respect 
of self-support or the ignominy of dependence — which 
shall the future hold for our disabled soldiers? The 
credit or the blame for the decision will largely rest 
with the American public. 

The open road is before us. 



Printed in the United States of America. 



'T^HE following pages contain advertisements of a few 
of the Macmillan books on kindred subjects. 



Reclaiming the Maimed 

A Handbook of Physical Therapy 



By 
R. TAIT McKENZIE, M.D. 

Major, Royal Army Medical Corps, 

Professor of Physical Therapy, 

University of Pennsylvania. 

Pocket Handbook Size; Waterproof Covers; profusely Illustrated 
with Photographs and Diagrams. Pricey $2,00, 

The remarkable work accomplished by Major McKenzie and as- 
sociates, by special authorization of the Surgeon General of the 
British Armies, in rehabilitating and returning to the battle front many 
thousands of men who were previously considered as permanently dis- 
abled, as well as his success in restoring and returning to civil pursuits 
thousands of others, is fully described in this important book. Not 
only does Major McKenzie explain what has been done, but he offers 
many new methods, together with brand new apparatus, while the text 
is supplemented by an unusual collection of photographs and drawings 
which make his material instantly applicable for use by the jnedical 
man, the masseur or nurse. 

Major McKenzie's methods of treatment are now actually being 
taught and practically applied in the hospitals of the Military Hospitals 
Commission of Canada along the lines described, while the Surgeon 
General's office of the United States Army has approved of and urged 
the immediate publication of the book. It is, therefore, particularly 
timely not only for practical use in war work, but in the rehabilitation 
of those crippled by accidents in industrial plants. 



THE MACMILLAN COMPANY 

Publishers 64-66 Fifth Avenue New York 



325 Group Contests for the Army, 
Navy and School 

By W. J. CROMIE 

Author of "Keeping Physically Fit," etc. 
With many illustrations. 

Cloth, i2mo» 

Here is a book which the leaders of boys' clubs, gymnasium 
instructors, Y. M. C. A. workers, as well as physical directors 
in army and navy camps, will find distinctly valuable. Its 
purpose is to build up strong bodies and it has been written 
by one who has had long experience in work with young men 
in this direction. In addition, there is the appeal of the con- 
test. Dr. Cromie has so arranged his text, that the desire to 
excel is implanted in his students. The book splendidly an- 
swers the requirements of those who have longed for some- 
thing which shall give the class or group in physical training 
something to do, which shall keep their interests keen and 
active and shall develop them physically, at the same time. 
The many illustrations make beautifully clear the author's 
instructions. 



THE MACMILLAN COMPANY 

Publishers 64-66 Fifth Avenue New York 



The New Public Health 



By Dr. HIBBERT WINSLOW HILL 

Director, Institute of Public Health, and Medical Officer of Health of Lon- 
don, Canada; Professor of Public Health, Western University. 

"Common sense distinctly marks the brilliant exposition 
of the methods employed in tracing the courses of epidemics 
by medical officers with modern training in progressive com- 
munities which Dr. Hill calls 'The New Pubhc Health.' .... 
The shifting back upon the individual his share of the responsi- 
bility which has been put upon the State is essential to the pre- 
vention and extirpation of disease. The author's style is vig- 
orous, so that it is impossible not to understand the points he 
makes; he hits out from the shoulder and puts into a few pages 
more hard sense than can be extracted from volumes of scien- 
tific report. It is a book that ever}' citizen who has any regard 
for his duties should read." — The Xeu' York Sun, 

"In an interesting way Dr. Hill has analyzed the revolu- 
tionary changes that have taken place in the pubHc attitude 
toward the public health, and studied the problem of the pub- 
lic apathy to constructive sanitation. His new book 'The New 
Public Health' is a surv^ey of the field, tracing first the dif- 
ferences between the old attitude and the new; and second, 
pointing out the actual achievements in public and individual 
defense against infection and contagion. . . . The book dis- 
cusses in detail the work of the pubhc health engineer, statis- 
tician and laborator}', particularly in reference to the public 
health of the future. . . . The work is optimistic, construc- 
tive, and gives a sound working knowledge of what has been 
done and a practical program for procedure in the future." — 
Philadelphia Public Ledger, 



THE MACMILLAN COMPANY 

Publishers 64-66 Fifth Avenue New York 



The Martial Adventures 
of Henry and Me 



By WILLIAM ALLEN WHITE 

Cloth, $1.50 

" A jolly book . . . truly one of the best that has yet 
come down war's grim pike." — New York Post. 

" Honest from first to last. . . . Resembles ' Innocents 
Abroad ' in scheme and laughter ... a vivid picture of 
Europe at this hour. Should be thrice blessed, for man 
and book light up a world in the gloom of war.'' — New 
York Sun. 

"A unique chronicle, genuine and sincere." — New 
York Times. 

Here is a book of truth and humor. One of the first 
stories by an American that tell what America has done 
and is doing ** over there." It is a tale such as Mark 
Twain would have written had he lived to do his bit in 
France. 

Two " short, fat, bald, middle-aged, inland Amer- 
icans " cross over to France with commissions from the 
Red Cross. Their experiences are told in a bubbling humor 
that is irresistible. The sober common sense and the 
information about the work going on in France — the way 
our men take hold and the French respond — go to make 
this the book all Americans have long been waiting for. 

The inimitable sketches of Tony Sarg, distributed 
throughout, lend a clever, human atmosphere to the text. 



THE MACMILLAN COMPANY 

Publishers 64-66 Fifth Avenue New York 



